Dermatofibrosarcoma Protuberans Back Lump (Dorsal Wall Ultrasound)

Dermatofibrosarcoma Protuberans – Back Lump (Dorsal Wall Ultrasound)

Dorsal wll Ultrasound Case Study Case Study No: R-26

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Dorsal Wall Ultrasound

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Technique: Real-time ultrasound examination of the dorsal wall was performed using a high-frequency linear transducer (7–12 MHz). Systematic evaluation of the posterior thoraco-lumbar region was carried out in longitudinal and transverse planes. Skin, subcutaneous tissue, muscle layers, and underlying soft tissue structures were assessed.
Clinical indication: Back swelling / Pain / Palpable dorsal wall lump / Suspected soft tissue lesion.

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Location: A poorly defined soft tissue lesion is noted in the right lateral dorsal wall involving the dermis and subcutaneous tissue. Soft Tissue Lesion: A poorly defined hypoechoic lesion is seen measuring approximately 4.5 × 2.2 cm. The lesion demonstrates extension from the dermis into the subcutaneous tissue with irregular margins. Internal echotexture appears relatively homogeneous. Muscle / Fascial Planes: No definite deep muscular invasion is evident on sonographic evaluation. Adjacent fascial planes appear maintained. Calcification / Necrosis: No obvious calcification or necrotic component is identified. Vascularity: Mild to moderate internal vascularity is noted on Doppler evaluation.

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Impression: Poorly defined hypoechoic soft tissue lesion involving the dermis and subcutaneous tissue of the right lateral dorsal wall with mild to moderate internal vascularity. Features are suggestive of dermatofibrosarcoma protuberans (DFSP).

Recommendation: Further evaluation with MRI is recommended for assessment of lesion depth and extent. Histopathological confirmation is mandatory. Wide local excision with oncological consultation is advised.

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Kindly Note:

Limitations / Technical Factors:
Ultrasound evaluation may be limited in assessing microscopic spread and complete depth of infiltrative soft tissue lesions.
MRI correlation and histopathological evaluation are essential for definitive diagnosis and surgical planning.
• This report is not valid for medico-legal purposes.

Fibrosarcoma Back Lump (Dorsal Wall Ultrasound)

Fibrosarcoma – Back Lump (Dorsal Wall Ultrasound)

Dorsal wll Ultrasound Case Study Case Study No: R-25

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Technique: Real-time ultrasound examination of the dorsal wall was performed using a high-frequency linear transducer (7–12 MHz). Systematic evaluation of the posterior thoraco-lumbar region was carried out in longitudinal and transverse planes. Skin, subcutaneous tissue, muscle layers, and underlying soft tissue structures were assessed.
Clinical indication: Back swelling / Pain / Palpable dorsal wall lump / Suspected soft tissue lesion.

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Location: An ill-defined soft tissue mass is noted in the right lateral dorsal wall involving the deep soft tissue and intermuscular plane. Soft Tissue Lesion: An ill-defined heterogeneous hypoechoic mass is seen measuring approximately 6.8 × 4.1 cm. The lesion demonstrates irregular margins with infiltration into adjacent soft tissues. Internal heterogeneity with focal areas suggestive of necrosis is noted. Muscle / Fascial Planes: Adjacent intermuscular and fascial planes appear infiltrated. No definite calcification is identified. Calcification / Necrosis: Focal internal heterogeneity suggests possible necrotic change. No calcification is seen. Vascularity: Moderate internal vascularity is noted on Doppler evaluation.

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Impression: Ill-defined heterogeneous infiltrative soft tissue mass involving the right lateral dorsal wall with moderate internal vascularity and possible necrotic change. Features are suspicious for fibrosarcoma.

Recommendation: Urgent MRI is recommended for assessment of local extent and staging. Histopathological confirmation is essential. Oncological referral is advised for further evaluation and management.

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Kindly Note:

Limitations / Technical Factors:
Ultrasound evaluation may be limited in characterization of deep soft tissue masses and assessment of complete locoregional extension.
MRI correlation and histopathological evaluation are essential for definitive diagnosis and staging.
• This report is not valid for medico-legal purposes.

Nodular Fasciitis Back lump ultrasound – dorsal wall lesions

Nodular Fasciitis – Back Lump (Dorsal Wall Ultrasound)

Dorsal wll Ultrasound Case Study Case Study No: R-25

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Dorsal Wall Ultrasound

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Technique: Real-time ultrasound examination of the dorsal wall was performed using a high-frequency linear transducer (7–12 MHz). Systematic evaluation of the posterior thoraco-lumbar region was carried out in longitudinal and transverse planes. Skin, subcutaneous tissue, muscle layers, and underlying soft tissue structures were assessed.
Clinical indication: Back swelling / Pain / Palpable dorsal wall lump / Suspected soft tissue lesion.

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Location: A focal soft tissue lesion is noted in the right lateral dorsal wall within the subcutaneous plane adjacent to the fascial layer.

Soft Tissue Lesion: A small well-defined hypoechoic lesion is seen measuring approximately 2.1 × 1.3 cm. The lesion appears mildly heterogeneous with a subtle surrounding hypoechoic halo. Muscle / Fascial Planes: Adjacent fascial planes appear preserved. No definite deep muscular invasion is identified. Calcification / Necrosis: No internal calcification or necrotic change is seen. Vascularity: Mild internal vascularity is noted on Doppler evaluation.

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Impression: Small well-defined hypoechoic soft tissue lesion involving the right lateral dorsal wall subcutaneous plane with mild internal vascularity. Features are suggestive of nodular fasciitis.

Recommendation: Clinical correlation is advised. Short-term follow-up ultrasound may be considered. Biopsy may be performed if the diagnosis remains uncertain or if interval increase in size is noted.

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Kindly Note:

Limitations / Technical Factors:
Ultrasound evaluation may be limited in characterization of soft tissue lesions and assessment of microscopic fascial extension.
Clinical correlation and histopathological evaluation may be required for definitive diagnosis.
• This report is not valid for medico-legal purposes.

Fibromatosis (Desmoid Tumor) Back lump ultrasound – dorsal wall lesions

Fibromatosis (Desmoid Tumor)– Back Lump (Dorsal Wall Ultrasound)

Dorsal wll Ultrasound Case Study Case Study No: R-24

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Dorsal Wall Ultrasound

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Technique: Real-time ultrasound examination of the dorsal wall was performed using a high-frequency linear transducer (7–12 MHz). Systematic evaluation of the posterior thoraco-lumbar region was carried out in longitudinal and transverse planes. Skin, subcutaneous tissue, muscle layers, and underlying soft tissue structures were assessed.
Clinical indication: Back swelling / Palpable dorsal wall lump / Suspected soft tissue lesion.

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Location: An ill-defined soft tissue lesion is noted in the right lateral dorsal wall, involving the deep subcutaneous and intermuscular plane. Soft Tissue Lesion: An ill-defined hypoechoic infiltrative lesion is seen measuring approximately 5.6 × 2.8 cm. The lesion demonstrates irregular margins with extension along fascial planes. Internal echotexture appears heterogeneous. Muscle / Fascial Planes: Mild infiltration of adjacent intermuscular and fascial planes is noted. No definite intramuscular fluid collection is identified. Necrosis / Calcification: No internal necrosis or calcification is seen. Vascularity: Mild internal vascularity is noted on Doppler evaluation.

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Impression: Ill-defined infiltrative hypoechoic soft tissue lesion involving the right lateral dorsal wall with extension along fascial planes and mild internal vascularity. Features are suggestive of fibromatosis (desmoid tumor).

Recommendation: Further evaluation with MRI is recommended for extent assessment. Histopathological confirmation is advised. Surgical or oncological consultation may be considered.

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Kindly Note:

Limitations / Technical Factors:
Ultrasound evaluation may be limited in assessing deep tissue extension and complete infiltrative extent of soft tissue lesions.
MRI correlation and histopathological evaluation are recommended for definitive characterization.
• This report is not valid for medico-legal purposes.

Soft tissue fibroma Back lump ultrasound – dorsal wall lesions

Soft tissue fibroma – Back Lump (Dorsal Wall Ultrasound)

Dorsal wll Ultrasound Case Study Case Study No: R-23

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Dorsal Wall Ultrasound

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Technique: Real-time ultrasound examination of the dorsal wall was performed using a high-frequency linear transducer (7–12 MHz). Systematic evaluation of the posterior thoraco-lumbar region was carried out in longitudinal and transverse planes. Skin, subcutaneous tissue, muscle layers, and underlying soft tissue structures were assessed.
Clinical indication: Back swelling / Pain / Suspected soft tissue lesion / Trauma / Infection / Screening.

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Muscle Layers: Visualized muscle planes appear normal in bulk and echotexture. No focal mass, tear, or intramuscular collection is identified. Fascial Planes: Fascial layers are intact with no evidence of fluid tracking or disruption.

Skin & Subcutaneous Tissue: Location: Right lateral dorsal wall, within the subcutaneous plane. (Typical location: subcutaneous tissue of trunk, extremities, or dorsal body wall.) Soft Tissue: No focal soft tissue mass, cystic lesion, or abscess is seen. Vascularity: No abnormal increased vascularity is noted on Doppler evaluation.

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Impression: Features suggestive of subcutaneous fibroma in the right lateral dorsal wall.

Recommendation: Clinical correlation is advised. Follow-up ultrasound may be considered if there is increase in size or symptoms. Histopathological confirmation can be considered if clinically indicated.

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Kindly Note:

• Sonographic findings are suggestive of a benign subcutaneous soft tissue fibroma / fibrous lesion involving the dorsal wall region.
• Ultrasound evaluation is limited in characterization of deep soft tissue extension and adjacent osseous involvement.
• Clinical correlation is advised. Histopathological examination, MRI, or follow-up imaging may be considered if the lesion enlarges, becomes painful, fixed, or clinically suspicious.
• This report is not valid for medico-legal purposes.

HEMOGLOBIN (Hb%)

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HEMOGLOBIN (Hb%) – MALE

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Method: Automated Hematology Analyzer / Cyanmethemoglobin Method

Parameter	Result	Units	Reference Range	Status
Hemoglobin	14.2	g/dL	13–17	Normal

Clinical Significance

Hemoglobin (Hb) is an iron-containing oxygen transport protein present in red blood cells. It is responsible for carrying oxygen from the lungs to body tissues and transporting carbon dioxide back to the lungs. Hemoglobin estimation is commonly used for evaluation of anemia, blood loss, nutritional deficiency states, polycythemia, and chronic systemic disorders.

Clinical Interpretation

• Hemoglobin level is within normal male reference range.
• No significant evidence of anemia detected.
• Clinical correlation recommended if symptoms persist.

If Hemoglobin is Abnormal

Low Hemoglobin: May suggest iron deficiency anemia, nutritional deficiency, blood loss, chronic disease, renal disorders, or bone marrow suppression.

High Hemoglobin: May occur in dehydration, smoking, chronic hypoxia, high-altitude exposure, chronic lung disease, or polycythemia.

Note: Hemoglobin values should always be interpreted along with RBC indices, hematocrit, peripheral smear findings, and clinical history. This report is not valid for medico-legal purposes.

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HEMOGLOBIN (Hb%) – FEMALE

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Method: Automated Hematology Analyzer / Cyanmethemoglobin Method

Parameter	Result	Units	Reference Range	Status
Hemoglobin	12.8	g/dL	12–15	Normal

Clinical Significance

Hemoglobin (Hb) is an iron-containing oxygen transport protein present in red blood cells. It is responsible for carrying oxygen from the lungs to body tissues and transporting carbon dioxide back to the lungs. Hemoglobin estimation is commonly used for evaluation of anemia, blood loss, nutritional deficiency states, polycythemia, and chronic systemic disorders.

Clinical Interpretation

• Hemoglobin level is within normal female reference range.
• No significant evidence of anemia detected.
• Clinical correlation recommended if symptoms persist.

If Hemoglobin is Abnormal

Low Hemoglobin: May suggest iron deficiency anemia, nutritional deficiency, blood loss, chronic disease, renal disorders, or bone marrow suppression.

High Hemoglobin: May occur in dehydration, smoking, chronic hypoxia, high-altitude exposure, chronic lung disease, or polycythemia.

Note: Hemoglobin values should always be interpreted along with RBC indices, hematocrit, peripheral smear findings, and clinical history. This report is not valid for medico-legal purposes.

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COMPLETE BLOOD COUNT (CBC) Normal/Abnormal

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COMPLETE BLOOD COUNT (CBC)

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Method: Automated Hematology Analyzer (5-Part Differential) with smear correlation

Parameter	Result	Units	Reference Range	Status
Hemoglobin	13.5	g/dL	M: 13–17 | F: 12–15	Normal
RBC Count	4.8	×10⁶/µL	4.5–5.5	Normal
Hematocrit	42	%	36–50	Normal
MCV	88	fL	80–100	Normal
MCH	29	pg	27–32	Normal
MCHC	34	g/dL	32–36	Normal
RDW	13	%	11.5–14.5	Normal
Total WBC	7800	/µL	4,000–11,000	Normal
Platelets	250000	/µL	150,000–450,000	Normal

Differential Leukocyte Count

Cell Type	Result (%)	Reference Range	Status
Neutrophils	55	40–75%	Normal
Lymphocytes	30	20–45%	Normal
Monocytes	6	2–10%	Normal
Eosinophils	3	1–6%	Normal
Basophils	0.5	0–1%	Normal

Peripheral Blood Smear

RBC: Normocytic normochromic red blood cells.
WBC: Total and differential leukocyte counts are within normal limits.
Platelets: Adequate in number with normal morphology.

Clinical Significance

Complete Blood Count (CBC) is a routine hematological investigation used to evaluate hemoglobin status, red blood cells, white blood cells, and platelets. It assists in screening for anemia, infection, inflammatory disorders, hematological diseases, and platelet abnormalities.

Clinical Interpretation

• Hematological parameters are within normal physiological limits.
• No evidence of anemia, leukocytosis, leukopenia, or platelet abnormality.
• Peripheral smear morphology appears unremarkable.
• Clinical correlation recommended if symptoms persist.

Note: Reference ranges may vary depending on age, gender, hydration status, infection, medications, and laboratory methodology. Clinical correlation is recommended. This report is not valid for medico-legal purposes.

If Abnormal CBC Test

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COMPLETE BLOOD COUNT (CBC)

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Method: Automated Hematology Analyzer (5-Part Differential) with smear correlation

Parameter	Result	Units	Reference Range	Status
Hemoglobin	8.6	g/dL	M: 13–17 | F: 12–15	Low
RBC Count	3.4	×10⁶/µL	4.5–5.5	Low
Hematocrit	28	%	36–50	Low
MCV	72	fL	80–100	Low
MCH	22	pg	27–32	Low
MCHC	29	g/dL	32–36	Low
RDW	18.5	%	11.5–14.5	High
Total WBC	15,800	/µL	4,000–11,000	High
Platelets	520,000	/µL	150,000–450,000	High

Differential Leukocyte Count

Cell Type	Result (%)	Reference Range	Status
Neutrophils	82	40–75%	High
Lymphocytes	12	20–45%	Low
Monocytes	4	2–10%	Normal
Eosinophils	2	1–6%	Normal
Basophils	0	0–1%	Normal

Peripheral Blood Smear

RBC: Microcytic hypochromic anemia with anisopoikilocytosis.
WBC: Neutrophilic leukocytosis noted. No atypical cells seen.
Platelets: Thrombocytosis present; platelet morphology appears adequate.

Clinical Interpretation

• Moderate microcytic hypochromic anemia suggestive of iron deficiency anemia.
• Neutrophilic leukocytosis likely related to acute infection or inflammatory process.
• Reactive thrombocytosis noted.
• Clinical correlation with iron profile, ferritin, and inflammatory markers is recommended.

Possible Causes

• Iron deficiency anemia
• Acute bacterial infection
• Chronic inflammatory disorders
• Blood loss / gastrointestinal bleeding
• Nutritional deficiency states
• Reactive marrow response

Note: Hematological values should be interpreted in conjunction with clinical findings and relevant biochemical investigations. This report is not valid for medico-legal purposes.

MALARIAL PARASITE (MP) BY Q.B.C METHOD Malarial parasite detected/Species identified as P. vivax / P. falciparum.

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MALARIAL PARASITE (MP) BY Q.B.C METHOD

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Method: Quantitative Buffy Coat (Q.B.C) Fluorescent Microscopy Method

Parameter	Result	Status
Malarial Parasite	Negative	Normal
Plasmodium Vivax	Not Detected	Normal
Plasmodium Falciparum	Not Detected	Normal

About Q.B.C Test

Q.B.C (Quantitative Buffy Coat) is a rapid fluorescence microscopy technique used for the detection of malarial parasites in peripheral blood samples. This method provides quick and sensitive screening for Plasmodium vivax and Plasmodium falciparum infections and is commonly used for early malaria diagnosis.

Clinical Interpretation

• No malarial parasite detected in the examined blood sample.
• Findings are suggestive of a negative screening result for malaria.
• Repeat testing may be advised if clinical suspicion persists, especially during early stages of infection or intermittent parasitemia.

Note: A negative result does not completely exclude malaria infection. Repeat examination may be necessary in clinically suspected cases, particularly during low parasitemia or early infection stages. Clinical correlation is strongly recommended. This report is not valid for medico-legal purposes.

Positive Findings (If Present)

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MALARIAL PARASITE (MP) BY Q.B.C METHOD

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Method: Quantitative Buffy Coat (Q.B.C) Fluorescent Microscopy Method

Parameter	Result	Status
Malarial Parasite	Detected	Positive
Plasmodium Vivax	Detected	Positive
Plasmodium Falciparum	Not Detected	—

About Q.B.C Test

Q.B.C (Quantitative Buffy Coat) is a rapid fluorescence microscopy technique used for detection of malarial parasites in peripheral blood. This method provides sensitive and rapid screening for Plasmodium vivax and Plasmodium falciparum infections and assists in early laboratory diagnosis of malaria.

Clinical Interpretation

• Malarial parasite detected in the examined blood sample.
• Findings are suggestive of malaria infection due to Plasmodium vivax.
• Correlation with clinical findings, complete blood count, and peripheral smear examination is advised.
• Appropriate antimalarial therapy and clinical follow-up are recommended.

• Fever with chills and rigors
• Sweating and generalized weakness
• Headache and body ache
• Nausea or vomiting
• Anemia or thrombocytopenia may be associated

Note: Positive Q.B.C findings are suggestive of malaria infection. Species confirmation and parasite quantification may be correlated with peripheral smear findings whenever clinically indicated. This report is not valid for medico-legal purposes.

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MALARIAL PARASITE (MP) BY Q.B.C METHOD

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Method: Quantitative Buffy Coat (Q.B.C) Fluorescent Microscopy Method

Parameter	Result	Status
Malarial Parasite	Detected	Positive
Plasmodium Vivax	Detected	Positive
Plasmodium Falciparum	Detected	Positive

About Q.B.C Test

Q.B.C (Quantitative Buffy Coat) is a rapid fluorescence microscopy technique used for detection of malarial parasites in peripheral blood samples. This method provides sensitive and rapid screening for Plasmodium vivax and Plasmodium falciparum and assists in early laboratory diagnosis of malaria infection.

Clinical Significance

Malaria is a parasitic infection transmitted through the bite of infected female Anopheles mosquitoes. Mixed infection with P. vivax and P. falciparum may be associated with fever, chills, anemia, thrombocytopenia, and systemic complications. Early diagnosis and treatment are important to prevent severe disease, especially in P. falciparum infection.

Clinical Interpretation

• Malarial parasite detected in the examined blood sample.
• Mixed malarial infection identified with Plasmodium vivax and Plasmodium falciparum.
• Findings are suggestive of active malaria infection.
• Correlation with clinical findings, CBC parameters, and peripheral smear examination is advised.
• Prompt antimalarial therapy and clinical monitoring are recommended.

Possible Clinical Features

• Fever with chills and rigors
• Sweating and generalized weakness
• Headache and body ache
• Nausea or vomiting
• Anemia and thrombocytopenia
• Hepatosplenomegaly in some cases
• Severe falciparum malaria may lead to systemic complications

Note: Positive Q.B.C findings are suggestive of malaria infection. Species confirmation and parasite quantification may be correlated with peripheral smear findings whenever clinically indicated. Early clinical management is advised, particularly in mixed or P. falciparum infections. This report is not valid for medico-legal purposes.

SERUM PHOSPHORUS Normal/Low/High

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SERUM PHOSPHORUS

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Method: UV Molybdate / Photometric Method

Parameter	Result	Units	Reference Range	Status
Serum Phosphorus	3.8	mg/dL	2.5 – 4.5	Normal

Clinical Significance

Phosphorus plays an important role in bone mineralization, energy metabolism, cell membrane integrity, and acid-base balance. Serum phosphorus levels are closely regulated by the kidneys, parathyroid hormone, and vitamin D.

Clinical Interpretation

• Serum phosphorus level is within normal physiological limits.
• No evidence of hypophosphatemia or hyperphosphatemia.
• Clinical correlation advised if renal, endocrine, or metabolic disorders are suspected.

Note: Reference ranges may vary depending on age, diet, renal status, and laboratory methodology. Clinical correlation is recommended. This report is not valid for medico-legal purposes.

Method: UV Molybdate / Photometric Method

Parameter	Result	Units	Reference Range	Status
Serum Phosphorus	1.9	mg/dL	2.5 – 4.5	Low

Clinical Significance

Phosphorus is essential for bone formation, cellular energy production, muscle and nerve function, and maintenance of acid-base balance. Low serum phosphorus levels (hypophosphatemia) may occur due to poor dietary intake, malabsorption, vitamin D deficiency, alcoholism, hyperparathyroidism, diabetic ketoacidosis recovery, or renal phosphate loss.

Clinical Interpretation

• Serum phosphorus level is below the normal reference range.
• Findings are suggestive of hypophosphatemia.
• Clinical correlation is advised with nutritional status, renal function, vitamin D levels, and parathyroid hormone status.
• Severe or persistent hypophosphatemia may be associated with muscle weakness, bone pain, fatigue, or metabolic disturbances.

Note: Reference ranges may vary depending on age, diet, renal status, and laboratory methodology. Clinical correlation is recommended. This report is not valid for medico-legal purposes.

Possible Causes of Hypophosphatemia

• Poor dietary intake or malnutrition
• Vitamin D deficiency
• Malabsorption syndromes / chronic diarrhea
• Hyperparathyroidism
• Chronic alcoholism
• Diabetic ketoacidosis recovery phase
• Renal phosphate wasting disorders
• Prolonged antacid use (aluminum/magnesium containing)
• Severe burns or sepsis
• Refeeding syndrome after prolonged starvation

Method: UV Molybdate / Photometric Method

Parameter	Result	Units	Reference Range	Status
Serum Phosphorus	5.8	mg/dL	2.5 – 4.5	High

Clinical Significance

Phosphorus plays an important role in bone mineralization, cellular energy production, muscle function, and acid-base balance. Elevated serum phosphorus levels (hyperphosphatemia) may result from impaired renal excretion, endocrine disorders, excessive phosphate intake, or cellular breakdown. Persistent elevation may contribute to soft tissue and vascular calcification, especially in patients with chronic kidney disease.

Clinical Interpretation

• Serum phosphorus level is above the normal reference range.
• Findings are suggestive of hyperphosphatemia.
• Correlation with renal function tests, calcium levels, parathyroid hormone, and vitamin D status is advised.
• Persistent hyperphosphatemia may require further evaluation to identify underlying renal, endocrine, or metabolic causes.

Note: Reference ranges may vary depending on age, diet, renal status, and laboratory methodology. Clinical correlation is recommended. This report is not valid for medico-legal purposes.

Possible Causes of Hyperphosphatemia

• Chronic kidney disease / renal failure
• Hypoparathyroidism
• Excessive vitamin D therapy or phosphate intake
• Tumor lysis syndrome or rhabdomyolysis
• Metabolic or diabetic ketoacidosis recovery phase
• Hemolysis or severe tissue breakdown
• Certain medications or phosphate-containing laxatives/enemas

Deep Paraspinal Intramuscular Lipoma Back lump ultrasound – dorsal wall lesions

Deep Paraspinal Intramuscular Lipoma – Back Lump (Dorsal Wall Ultrasound)

Deep Musculoskeletal (Paraspinal) Ultrasound Case Study Case Study No: R-22

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Dorsal Wall Ultrasound

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Technique: Real-time ultrasound examination of the posterior lumbar dorsal wall was performed using a high-frequency linear transducer (7–12 MHz), supplemented with a low-frequency curvilinear probe where required for deeper evaluation. Systematic assessment of the paraspinal region was performed in longitudinal and transverse planes. Skin, subcutaneous tissue, paraspinal muscle layers, and deeper soft tissue structures were evaluated.
Clinical indication: Suspected soft tissue lesion

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Skin & Subcutaneous Tissue: Skin thickness appears normal. Subcutaneous tissue shows normal echotexture with no edema or collection.

Muscle Layers: In the posterior lumbar paraspinal region, a well-defined hyperechoic lesion is noted within the deep paraspinal muscle plane (likely involving erector spinae / multifidus group), measuring approximately 4.3 × 2.0 cm.
The lesion demonstrates homogeneous fatty echotexture with fine internal linear echogenic striations, oriented parallel to muscle fibers. No surrounding muscle invasion or architectural distortion is identified. Fascial Planes: Fascial planes appear preserved with no evidence of disruption or fluid tracking. Soft Tissue: No additional focal soft tissue mass, cystic lesion, or abscess is seen. Vascularity: No internal vascularity is noted within the lesion on Doppler evaluation.

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Impression: Well-defined intramuscular hyperechoic lesion within the deep paraspinal muscles, demonstrating characteristic sonographic features of a lipoma.
Features are suggestive of deep paraspinal intramuscular lipoma.

Recommendation: Clinical correlation is advised. MRI may be considered for further evaluation, particularly to assess depth and extent. Follow-up is recommended if symptomatic or showing interval increase in size.

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Kindly Note:

Limitations / Technical Factors:
Ultrasound evaluation is limited for deep-seated lesions and bony structures.
Clinical correlation and further imaging (MRI / CT) may be required depending on clinical suspicion.

• This report is not valid for medico-legal purposes.

End of Case Study

You have reached the end of this Deep Paraspinal Intramuscular Lipoma – Back Lump (Dorsal Wall Ultrasound Case Study).

This evaluation was performed using Ultrasonography (USG), enabling real-time assessment of deep musculoskeletal soft tissue structures.

Content is intended for educational, training, and clinical reference purposes only.

Declaration:
I, R. K. Mouj, declare that the material presented in this case study titled “Deep Paraspinal Intramuscular Lipoma – Dorsal Wall (Back Lump) on Ultrasonography (USG)” has been prepared solely for educational and academic purposes. The findings demonstrate a well-defined, hyperechoic lesion located within the deep paraspinal muscle plane (erector spinae / multifidus group) in the posterior lumbar region, consistent with an intramuscular lipoma. The lesion shows homogeneous fatty echotexture with fine internal linear striations, oriented parallel to muscle fibers, with absence of internal vascularity on Doppler imaging. No surrounding soft tissue infiltration or aggressive features are identified. Ultrasonography is a useful, non-invasive modality for evaluating soft tissue masses; however, assessment of deep lesions may be limited, and further imaging such as MRI may be required. These findings are intended for educational and demonstration purposes only. Definitive diagnosis and management require clinical correlation and appropriate medical consultation.

Author: ____________________
Name: R. K. Mouj [Radio-imaging Technologist]
Domain: Diagnostic Sonography & Musculoskeletal Imaging
Modality: Ultrasonography (USG)
Platform: SonoAcademy
Supervisor / Guide: Department Radiologist
Department: Radiology

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© SCRS – Sonographic Classified Reporting System

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Psoas (Posterior Extension) Lipoma Back lump ultrasound – dorsal wall lesions

Psoas Muscle Lipoma (Posterior Extension) – Back Lump (Dorsal Wall Ultrasound)

Deep Musculoskeletal Ultrasound Case Study Case Study No: R-21

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Dorsal Wall Ultrasound

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Technique: Real-time ultrasound examination of the posterior lumbar dorsal wall was performed using a high-frequency linear transducer (7–12 MHz), supplemented with a low-frequency curvilinear probe where required for deeper evaluation. Systematic assessment of the paraspinal and posterior abdominal wall region was performed in longitudinal and transverse planes. Skin, subcutaneous tissue, muscle layers, and deeper soft tissue structures were evaluated.
Clinical indication: Suspected soft tissue lesion

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Skin & Subcutaneous Tissue: Skin thickness appears normal. Subcutaneous tissue shows normal echotexture with no edema or collection.

Muscle Layers: In the posterior lumbar paraspinal region, a well-defined hyperechoic lesion is noted, extending into the posterior aspect of the psoas muscle (posterior extension), measuring approximately 4.3 × 2.0 cm.
The lesion demonstrates homogeneous fatty echotexture with fine internal linear striations. No surrounding muscle invasion or architectural distortion is identified. Fascial Planes: Fascial planes appear preserved with no evidence of disruption or fluid tracking. Soft Tissue: No additional focal soft tissue mass, cystic lesion, or abscess is seen. Vascularity: No internal vascularity is noted within the lesion on Doppler evaluation.

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Impression: Well-defined hyperechoic lesion involving the posterior extension of the psoas muscle, showing sonographic features suggestive of a lipoma.
Features are suggestive of intramuscular (psoas muscle) lipoma.

Recommendation: Clinical correlation is advised. Due to deep location and limited ultrasound evaluation, MRI is recommended for further characterization and extent assessment. Follow-up is advised if symptomatic or increasing in size.

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Kindly Note:

Limitations / Technical Factors:
Ultrasound evaluation is limited for deep-seated lesions and bony structures.
Clinical correlation and further imaging (MRI / CT) may be required depending on clinical suspicion.

• This report is not valid for medico-legal purposes.

End of Case Study

You have reached the end of this Levator Scapulae Muscle Lipoma – Back Lump (Dorsal Wall Ultrasound Case Study).

This evaluation was performed using Ultrasonography (USG), allowing real-time assessment of superficial and deep musculoskeletal soft tissue structures.

Content is intended for educational, training, and clinical reference purposes only.

Declaration:
I, R. K. Mouj, declare that the material presented in this case study titled “Levator Scapulae Muscle Lipoma – Dorsal Wall (Back Lump) on Ultrasonography (USG)” has been prepared solely for educational and academic purposes. The findings demonstrate a well-defined, hyperechoic lesion located within the intramuscular plane of the levator scapulae muscle, extending from the upper cervical region to the superior angle of the scapula, deep to the trapezius muscle, consistent with an intramuscular lipoma. The lesion shows homogeneous fatty echotexture with fine internal linear striations, oriented parallel to muscle fibers, with absence of internal vascularity on Doppler imaging. No surrounding soft tissue infiltration or aggressive features are identified. Ultrasonography is a reliable, non-invasive modality for evaluating both superficial and deep soft tissue masses, aiding in differentiation of benign lesions such as lipoma from other pathological conditions. These findings are intended for educational and demonstration purposes only. Definitive diagnosis and management require clinical correlation and appropriate medical consultation.

Author: ____________________
Name: R. K. Mouj [Radio-imaging Technologist]
Domain: Diagnostic Sonography & Musculoskeletal Imaging
Modality: Ultrasonography (USG)
Platform: SonoAcademy
Supervisor / Guide: Department Radiologist
Department: Radiology

⬆ Back to Top

© SCRS – Sonographic Classified Reporting System

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