Sonographic features of secondary involvement of skin and subcutaneous tissues by hematologic malignancies

Objectives To evaluate the sonographic features of secondary involvement of skin and subcutaneous tissues by hematologic malignancies. Methods A review of the ultrasound and pathology databases yielded 10 cases with 13 skin and subcutaneous tissue lesions secondary to hematologic neoplasms, which were confirmed by pathology. We used ultrasound to assess the number, location, size, depth of involvement, echogenicity, and vascularity of the lesions. Results The study involved five male and five female patients, including four leukemia, two multiple myeloma, and four lymphoma patients. The average age was 45 years (17–66 years). Three patients presented with one lesion, four with two lesions, and three with more than two lesions. All the lesions were located in the trunk and extremities. The lesions ranged from 1.2 to 8.3 cm in size. A total of 10 lesions involved subcutaneous fat tissue. A total of 10 lesions displayed hypoechoic foci within a hyperechoic background, and three appeared hypoechoic, and most of them exhibited abundant vascularity (12 of 13 lesions). Conclusions Secondary involvement of skin and subcutaneous tissues by hematologic malignancies often present with multiple palpable masses showing the following ultrasound features: (1) subcutaneous fat infiltration, (2) hypoechoic foci with a hyperechoic background, and (3) abundant vascularity. Skin and subcutaneous soft tissues involved in hematologic neoplasms often present with multiple palpable masses showing the following imaging features: (1) subcutaneous fat infiltration, (2) hypoechoic foci with a hyperechoic background, and (3) abundant vascularity.