Nama: Dyah Putri Mentari Ginting

NIM : I4A013043

1. Radiographic features of Pulmonary metastases

1. Pneumonia tipe
2. Miliary tipe
3. Coin lesion
4. Fungus ball
5. Interstitial pulmonary disease type
6. Efusion type
7. Pneumothorax type (osteosarkoma)

Pulmonary metastases typically appear as 5

1. Peripheral,
2. Rounded nodules of variable size,
3. Scattered throughout both lungs
Atypical features include
1. Consolidation,
2. Cavitation,
3. Calcification,
4. Haemorrhage, and
5. Secondary pneumothorax.

2. Benign and malignant characteristics of breast lesions at ultrasound

Malignant characteristics (with positive predictive values)
 sonographic spiculation: 87-90% 1,4
o alternate hypo-hyperechoic lines radiating perpendicularly from surface of nodules (if
lesion is surrounded by echogenic tissue, hypoechoic strands will be seen; if lesion is
surrounded by fat, echogenic strands may be seen)
 deeper (taller) than wide: 74-80% 1,4
o except in certain grade III Invasive ductal carcinomas
 microlobulations: 75%
o small lobulations 1-2 mm on the surface; risk of malignancy rises with increasing
numbers
 thick hyperechoic halo: 74%
 angular margins: 70%
 markedly hypoechoic nodule: 70%
 sonographic posterior acoustic shadowing: 50%
 branching pattern: 30%
o multiple projections from the nodule within or around ducts extending away from the
nipple, usually seen in larger tumours
 punctate calcifications: 25%
o which usually do not shadow
 duct extension: 25%
o is seen as projection from a nodule which extends radially within or around a duct
towards the nipple
 heterogeneous echotexture 3
 compressibility
o in general terms, benign lesions compress with transducer pressure and malignant
lesions displace the breast tissue without changing in height; this is the basis
for elastography

Benign characteristics (with negative predictive values)

 well circumscribed, hyperechoic tissue: ~100%
 wider than deep: 99%
 gently curving smooth lobulations (<3 in a wider than deep nodule, i.e. D/W ratio <1):
99%
 thin echogenic pseudocapsule in a wider than deep nodule: 99%
o it is best seen on anterior/posterior margins, perpendicular to the beam
o probably represents normal compressed tissue consistent with a non-infiltrative process
References
1. Stavros AT, Thickman D, Rapp CL et-al. Solid breast nodules: use of sonography to
distinguish between benign and malignant lesions. Radiology. 1995;196 (1): 123-34.
2. Rahbar G, Sie AC, Hansen GC et-al. Benign versus malignant solid breast masses: US
differentiation. Radiology. 1999;213 (3): 889-94.
3. Cardeñosa G. Clinical breast imaging, a patient focused teaching file. Lippincott Williams
& Wilkins. (2006) ISBN:0781762677
4. Paredes ES. Atlas of mammography. Lippincott Williams & Wilkins. (2007)
ISBN:0781764335.
5. Seo JB, Im JG, Goo JM et-al. Atypical pulmonary metastases: spectrum of radiologic
findings. Radiographics. 21 (2): 403-17.