From the Guidelines
A hyperechoic mass is a structure that appears brighter or whiter than surrounding tissues when viewed on an ultrasound image, often representing fat, fibrous tissue, calcifications, or certain types of tumors, such as lipomas or inflammatory fibroid polyps, as seen in studies 1.
Definition and Characteristics
A hyperechoic mass is characterized by its increased echogenicity, which results from the physical properties of the tissue, particularly its density and acoustic impedance. When ultrasound waves encounter interfaces between tissues with different acoustic properties, they reflect back with varying intensities, creating the characteristic bright appearance.
Clinical Significance
While hyperechoic masses can be benign, they may also represent malignant lesions in some cases, which is why further evaluation through additional imaging or biopsy is often necessary for definitive diagnosis. The location, size, shape, margins, and internal characteristics of the hyperechoic mass, along with clinical context, help determine its significance and guide appropriate management.
Diagnostic Approaches
Endoscopic ultrasound (EUS) has become a valuable tool in characterizing subepithelial lesions, including hyperechoic masses, by determining the layer of origin, size, echogenicity, and presence of blood vessels on Doppler flow, as noted in studies 1. EUS can help narrow down the differential diagnosis and has therapeutic implications for endoscopic resection.
Key Points
- Hyperechoic masses can represent various types of tissue, including fat, fibrous tissue, calcifications, or certain types of tumors.
- EUS is a useful tool in characterizing subepithelial lesions, including hyperechoic masses.
- Further evaluation through additional imaging or biopsy is often necessary for definitive diagnosis.
- The location, size, shape, margins, and internal characteristics of the hyperechoic mass, along with clinical context, help determine its significance and guide appropriate management, as discussed in studies 1.
From the Research
Definition of Hyperechoic Mass
- A hyperechoic mass is a type of lesion that appears brighter than the surrounding tissue on ultrasound imaging 2, 3, 4, 5, 6.
- This is because the mass has a higher echogenicity, meaning it reflects more sound waves back to the ultrasound probe.
Characteristics of Hyperechoic Masses
- Hyperechoic masses are often benign, but can also be malignant 3, 4, 5, 6.
- Benign hyperechoic masses can include lesions such as lipoma, hematoma, seroma, fat necrosis, abscess, and pseudoangiomatous stromal hyperplasia 4, 5.
- Malignant hyperechoic masses can include invasive ductal carcinoma, invasive lobular carcinoma, metastasis, lymphoma, and angiosarcoma 2, 3, 4, 5, 6.
Ultrasound Features of Hyperechoic Masses
- Hyperechoic masses can have varying ultrasound features, including a hypoechoic center and hyperechoic rim, or a dispersed pattern with hyperechoic areas throughout the lesion 2.
- Malignant hyperechoic masses are more likely to have non-circumscribed margins, non-parallel orientation, and a hypoechoic area 3, 6.
Importance of Correlation with Other Imaging Modalities
- Hyperechoic masses should be correlated with mammographic findings and clinical history to determine the need for biopsy 3, 5, 6.
- Lesions with worrisome features such as a spiculated margin, interval enlargement, interval vascularity, or association with suspicious microcalcifications on mammography require biopsy 5.