Multimodal ultrasonography of male primary breast lymphoma

① Gray scale ultrasound showed multiple hypoechoic masses of varying sizes in the right breast. The larger one was 1.8 × 0.7 cm (arrow), oval in shape, with clear boundaries, and lymphatic hilar-like structures. ② Color Doppler ultrasonography showed blood flow signals within the hypoechoic mass, and the larger (arrow) mass showed blood flow signals similar to lymphatic hilum. ③ Elastography showed the mass was soft and blue (short arrow) or green (long arrow) in texture, and the surrounding tissue was hard and red in texture. ④ Contrast-enhanced ultrasound showed that after 19 s of contrast agent injection, the whole breast showed a 'snowflake' high enhancement, but no enhancement was observed in local areas (arrow). ⑤ The ultrasound-guided puncture image clearly showed the puncture needle (arrow) insert into the hypoechoic mass for biopsy. ⑥ The arrow in the pathological image (HE, 20 × 10 times) showed tumor cells.