Diagnostic ultrasound ( PDFDrive )

CHAPTER 21 The Breast 781
R 3 2A RAD
Superficial/palp
A B C
FIG. 21.30 Benign Sebaceous Skin Cysts. (A) Sebaceous cyst is entirely within the skin (calipers). Extra gel has been used as a stand off
pad for scanning (arrows). (B) Cyst is primarily within the subcutaneous fat, but a thin “claw sign” of echogenic skin (arrows) can be shown to
wrap around the cyst, conirming that it originates within the skin. (C) Cyst is entirely within the subcutaneous fat, but a dilated and obstructed
gland neck can be seen coursing obliquely through the skin (arrowhead). A standoff of acoustic gel is necessary to see these lesions. To show the
obliquely oriented hair follicle, heeling or toeing of the transducer may be necessary.
A
C
Supine D UPRT 5 min E
B
FIG. 21.31 Foam and Acorn Cysts. (A) Foam cysts are illed with diffuse low-level echoes and can be dificult to distinguish from solid
nodules. Foam cysts have also been called inspissated cysts, gel cysts, and mucoceles. (B) Acorn cysts have an echogenic concave rim of papillary
apocrine metaplasia (PAM) that appears similar to the cap on an acorn. Unlike similar-appearing lipid layers within cysts that have fat-luid levels,
the position of the PAM does not change from the supine (C) to the upright (D) or left lateral decubitus position. (E) Color Doppler ultrasound
image shows that, unlike intracystic papillomas or carcinomas, PAM rarely has a demonstrable vascularity.