Journal reading

HYPERECHOIC LESIONS OF THE BREAST

: RADIOLOGIC-HISTOPATHOLOGIC
CORRELATION
Oleh:
ELLYA RISMAYAN SARI
1110070100190
Preseptor:
dr. Dessy Wimelda, Sp.Rad

Benign Conditions
1. Hematoma
. Hyperacute anechoic
. Acute
Hypoechoic
. Subacute
complex cystic +
solid masse with indistinc margins
or a thick hyperechoic wall

 Chronic phases blood within the

hematoma become increasingly
hyperechoic

Circumscribed homogeneously hyperechoic mass

2. Abscess

Hyperechoic mass with marked internal hypervascularity

Hyperechoic accumulation of WBCs

3. Fat Necrosis

Right lateromedial
mammogram shows oval
isodense mass (arrow) with
indistinc margins at area of
palpable concern (triangle)

Hyperechoic mass with

indistinc margins
(arrow) and
heterogenous internal
hypoechogenicity.

Photomicograph
aggregates of foamy
macropagh (arrows) admixed
with lymphoplasmacytic
infiltrates (arrowhead)

Benign Neoplasma
1. Hamartoma
Ultrasound oval circumscribed solid
masses. may be hypoechoic,
hyperechoic, or have heterogeneus
echogenicity.

Cranioaudad mammogram
show oval, circumscribed, fat
containing mass (arrow)

Solid oval mixed

echogenicity mass
predominantly
hyperechoic

2. Lactating Adenoma
Mammogram oval masses with
radiolucent areas

Ultrasound often oval in shape, with

circumsribed margins, and a homegeneous
echotexture.

Back to back
glandular
proliferation.

3. Angiolipoma

Small mass with indistinc margins.

Progessively enhancing mass (arrow)

Two tumor component admixed:

Vascular component + adipose
tissue

4. Myofibroblastoma

Oval mixed density fat

containing mass (arrow)

Oval hyperechoic mass with circumscribed margins

(arrow).
Note attenuation of ultrasound bearn related to fat
component (arrowheads)

Spindle cell proliferation admixed with adipocytes.

5. Hemangioma

Right mediolateral mammogram

lobular noncalcified mass with
microlobulated margin (arrow)

Superficially located,
solid, oval,
hyperechoic mass

Dilated vessels with bland endothelial lining (arrows)

Focal chronic inflammation is present in stroma

Malignant Masses
1. Invasive and in situ ductal
carcinoma

Oval isodense mass with speculated marg

Irreguler
predominantly
hyoerechoic
mass with
indistinc
margin.

Glandular and nested

tumor cells infiltrating
fibroadipose tissue,
consistent with
invasive ductal cancer.

2. Invasive lobular
carcinoma
Architectural distortion (long arrow)
corresponding with palpable
abnomality (triangle) with biopsy clip
marker in posteroinferior margin
(short arrow).

Irreguler heterogeneous
predominantly
hyperechoic mass
(arrows)

3. Lymphoma

l heterogeneous predominantly hyperechoic mass

Oval non calcified

mass (arrow) with
indistinc posterior
margins at site of
palpable concern
(triangle)

Intermediate to large sized atypical lymphoid cell

4. Angiosarcoma

Solid heterogeneous primarily hyperechoic

mass with indistinc margin

Irregular
noncalcified mass
with indistinc
margin.

Anastomosing vascular
channels (asterisk) that
infiltrate into adjacent lobular
structures

5. Liposarcoma

Solid hyperechoic mass with indistinc marg

Tumor is composed of
celullar moderate to
markedly atypical celss
admixed with
multivacyolated
lipoblast

Conclusion
Hyperechoic masses are frequently
benign, including hematoma, fat necrosis,
abscess, and benign neoplasm. Malignant
hyperechoic lesions include invasive
ductal and invasive lobular carcinoma,
lymphoma, and sarcoma. Understanding
lesion echotexture in the context of
clinical and mammographic findings will
help establish appropriate diagnoses for
hyperechoic masses.

THANK YOU