Dorsal Wall Ultrasound
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 Palpable lump.
Location: Right lateral dorsal wall, involving deep soft tissue.
Skin & Subcutaneous Tissue: A large predominantly hyperechoic lesion is seen measuring approximately 7.5 × 3.8 cm. The lesion shows thick internal septations and mild heterogeneity. Mild internal vascularity may be present. No obvious invasion into adjacent structures.
Muscle Layers: Underlying muscle planes appear normal in bulk and echotexture. No intramuscular extension is identified.
Fascial Planes: Fascial layers are intact with no disruption or deep extension.
Vascularity: No internal vascularity is noted on Doppler evaluation.
Impression: Features suspicious for atypical lipomatous tumor.
Recommendation: Clinical correlation is advised. Further evaluation with MRI (preferred) is recommended for detailed tissue characterization and extent assessment. Histopathological confirmation is strongly advised to exclude well-differentiated liposarcoma.
Kindly Note:
Limitations / Technical Factors:
Ultrasound evaluation of dorsal wall soft tissue lesions may be limited in
accurately assessing deep extension and internal complexity.
Atypical lipomatous tumors may demonstrate heterogeneous echotexture with
thick septations, nodular non-fatty components, and internal vascularity,
which may not be fully characterized on ultrasound.
Features suggestive of malignancy may be underestimated on sonographic evaluation alone.
Further evaluation with MRI (preferred) is strongly recommended for
precise tissue characterization and differentiation from
well-differentiated liposarcoma.
Clinical correlation is essential.
• This report is not valid for medico-legal purposes.
End of Case Study
You have reached the end of this Atypical Lipomatous Tumor (ALT) – Back Lump (Dorsal Wall Ultrasound Case Study).
This evaluation was performed using Ultrasonography (USG), allowing real-time assessment of superficial soft tissue structures.
Content is intended for educational, training, and clinical reference only.
Declaration:
I, R. K. Mouj, declare that the material presented in this case study titled
“Atypical Lipomatous Tumor (ALT) – Dorsal Wall (Back Lump) on Ultrasonography (USG)”
has been prepared solely for educational and academic purposes.
The findings demonstrate a predominantly fatty soft tissue lesion located in the
subcutaneous or deep soft tissue plane of the dorsal wall, showing areas of
heterogeneity, internal thick septations, and possible mild vascularity.
These features raise suspicion for an atypical lipomatous tumor (ALT).
On ultrasound, ALT may appear similar to lipoma but often demonstrates
irregular margins, thickened septa, and non-uniform echotexture.
These lesions are considered low-grade malignant (well-differentiated liposarcoma spectrum)
and require careful evaluation.
Ultrasonography provides an initial assessment; however,
MRI is essential for characterization and extent evaluation,
and histopathological confirmation is mandatory for definitive diagnosis.
These findings are intended for learning and demonstration only.
Definitive diagnosis and management require clinical correlation and specialist consultation.
Author: ____________________
Name: R. K. Mouj [Radio-imaging Technologist]
Domain: Diagnostic Sonography & Soft Tissue Imaging
Modality: Ultrasonography (USG)
Platform: SonoAcademy
Supervisor / Guide: Department Radiologist
Department: Radiology
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