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, within subcutaneous tissue (Upper back.)
Skin & Subcutaneous Tissue: A well-defined heterogeneous lesion is seen measuring approximately 4.0 × 2.2 cm. The lesion shows mixed echogenicity with both fatty and fibrous components. Minimal internal vascularity is noted. No surrounding invasion is seen.
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 suggestive of spindle cell / pleomorphic lipoma.
Recommendation: Clinical correlation is advised. Further evaluation with MRI may be considered in case of atypical features. Histopathological confirmation is recommended for definitive diagnosis.
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 and non-fatty components, which may not be fully characterized on ultrasound.
Subtle features suggestive of malignancy, including internal nodularity and vascularity,
may be underestimated on sonographic evaluation.
Further evaluation with MRI (preferred) is strongly recommended for
detailed tissue characterization, extent assessment, 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 Spindle Cell / Pleomorphic Lipoma – 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
“Spindle Cell / Pleomorphic Lipoma – Dorsal Wall (Back Lump) on Ultrasonography (USG)”
has been prepared solely for educational and academic purposes.
The findings demonstrate a well-defined soft tissue lesion located in the
subcutaneous plane of the dorsal wall, showing variable echogenicity due to
mixed adipose and fibrous components, consistent with a
spindle cell / pleomorphic lipoma.
On ultrasound, these lesions may appear heterogeneous with internal linear echoes,
fibrous strands, and occasional mild vascularity. They are benign variants of lipoma,
commonly seen in middle-aged to elderly individuals, especially in posterior neck and back.
Ultrasonography plays a key role in identifying lesion characteristics,
though histopathological evaluation may be required for definitive diagnosis,
especially to differentiate from atypical lipomatous tumors.
These findings are intended for learning and demonstration only.
Definitive diagnosis and management require clinical correlation and appropriate medical 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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