Imaging Findings of Chest Wall Lesions on Breast Sonography

Abstract

Objective. The purpose of this presentation is to illustrate the sonographic findings of chest wall lesions that were depicted on breast sonography. Methods. Chest wall lesions detected during breast sonography were collected and reviewed retrospectively. Results. The sonographic findings of normal chest walls and various pathologic chest wall lesions, including inflammatory lesions, benign neoplasms, and malignant neoplasms, are discussed. Conclusions. Familiarity with normal sonographic anatomy and chest wall lesions could be helpful in differentiating a chest wall lesion from a breast lesion and in showing whether the origin of any palpable breast lump is in the breast parenchyma or the chest wall on breast sonography.

Primary breast leiomyosarcoma located in the premammary zone: a case report

“…It was located in the premammary zone, not in the mammary fibroglandular zone which is the common layer for developing breast cancer. A mass in the subcutaneous fat layer suggests the possibility of various neoplasms, such as metastatic tumors, hemangioma, neurogenic tumor, and soft tissue sarcoma, rather than tumors of fibroglandular origin such as fibroadenoma or recurring breast cancer [12]. Since breast sarcomas have no specific radiological features that can be differentiated from benign tumors, we should expand the list of differential Definitive diagnosis can be made by surgical biopsy and immunohistochemical studies, because fine-needle aspiration biopsy and core-needle biopsy are reported to underdiagnose the tumors [2,6,11].…”

Sonography of the chest wall: A pictorial essay

“…The chest wall consists of four layers: the skin, subcutaneous fat, superficial muscles, and the ribs and intercostal muscles . The skin appears sonographically as a thin hyperechoic layer.…”

“…A retromammary fat layer is located between the breast parenchyma and the pectoral muscle. Lesions originating from the chest wall displace this retromammary fat layer superficially …”

“…This pattern of destruction allows a metastatic rib fracture to be readily distinguished from a traumatic rib fracture (Figure A). US usually shows an irregularly disrupted anterior cortical line possibly associated with increased acoustic transmission . US is useful when patients experience localized chest pain of unknown cause, although overall, bone scintigraphy or positron emission tomography with fluorodeoxyglucose is much more sensitive than US at detecting bony metastases .…”

“…Primary malignant tumors , such as dermatofibrosarcoma protuberans or malignant fibrous histiocytoma, are rare . Metastases to the soft tissue of the chest wall are uncommon, usually occurring in patients who have extensive metastatic disease (Figure ). On US, the most useful sign of a sarcoma or a metastasis, which may occur in either the subcutaneous or the muscle layer, is that its appearance does not conform to the recognized appearance of any benign soft tissue mass.…”