Angioleiomyoma (ALM) is a rare benign, vascular smooth muscle tumor originating from the tunica media of the vessel wall. It typically arises in the cutaneous, subcutaneous tissue of the lower extremities in middle-aged women and is less than 2 cm in diameter. We report an ALM of the thigh in a 69-year-old woman with intermittent pain. US was performed with a high-resolution, broad-band (5 MHz-18 MHz) linear transducer for the superficial nodule. To the best of our knowledge, there has been no report of high-resolution ultrasound image features, including grayscale US, color Doppler US and Real-Time Tissue Elastography (RTE) for an ALM. ALM should be considered as one of the painful and vascularized subcutaneous mass, a superficial location that can be seen on high-resolution US. The feature of adjacent blood flow signal on color Doppler US could be strongly suggested to be ALM.

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A 41-year-old woman noticed a mass on the inside of her right thigh in April 2003. Ultrasound examination revealed a mass measuring 18 mm × 10 mm × 10 mm in the subcutaneous fatty tissues. Its boundary was relatively clear, with rough edges. The interior of the lesion was hyperechoic and contained an irregular hypoechoic area in its center; a color Doppler sonographic examination detected no blood flow signals. Incision biopsy examination seemed warranted. Pathologically, the specimen showed a proliferation of fibroblast-like spindle-shaped cells but no atypical cells. Immunologic staining revealed that sections were positive to vimentin; negative to CD34, CD68, α-smooth muscle actin (α-SMA), and S-100 protein; and mildly positive to HHF35. These results led to a diagnosis of nodular fascitis. Nodular fascitis is not common, and few studies have described its sonographic characteristics. We therefore used ultrasound to follow up the patient and found that the lesion was markedly smaller 3 months after the first examination, at which time it was hardly discernible as a mass. Here we compare the ultrasound and pathologic findings, and report the results of a bibliographic study.

Dermatologic ultrasound imaging has been rapidly growing in recently years because of the development of high-resolution

In recently years, dermatologic ultrasound imaging has been rapidly developed [1]. DERMUS (Dermatologic Ultrasound), the international working group, was formed and provided the guidelines for performing dermatologic ultrasound examinations [1] and proposed for an assessment training program [2]. Lipoma, common entity is regarded as level 1 content of the training program by DERMUS [2]. Soft-tissue lipomas are the most common type of benign mesenchymal tumors and are classified into two types, namely superficial and deep types. Superficial lipomas occur in the subcutaneous tissues, while deep-seated types occur deep to the investing fascia. Histologically, both subcutaneous and deepseated lipomas are comprised of mature adipose cells. Deep-seated lipomas are less common than ordinary superficial types [3]. In this article, the current knowledge of superficial and deep-seated lipomas on US features including gray-scale US, color Doppler US and RTE with MRI findings will be reviewed in detail. Dermatologic Ultrasound Dermatologic ultrasound imaging has been rapidly growing in recently years because of the advent of high-resolution multifrequency transducers and multichannel color Doppler machines [1]. The minimum frequency recommended for performing dermatologic examinations by DERMUS was 15 MHz [2] Lipoma is considered as level 1 content of the training program by DERMUS [2]. We usually perform US examinations for dermatologic lesions with a high-resolution, broad-band (5MHz-18MHz) linear transducer (Nobulus Hitachi, Ltd. Tokyo, Japan). We have provided several studies in the dermatologic field [4-11].

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