Multimode Ultrasound Features in Skeletal Muscle Lymphoma: A Retrospective Observational Study

This study aimed to evaluate the ultrasound findings in skeletal muscle lymphoma and investigate the correlations between ultrasound findings and histopathological characteristics.

Ultrasonographic images with skeletal muscle lymphoma obtained between June 2014 and June 2024 were retrospectively reviewed. The ultrasonographic examinations comprised gray-scale (n = 35), color-Doppler (n = 35), contrast-enhanced (n = 5), and elastography imaging (n = 5). Biopsy samples underwent histopathological analysis to identify the histopathologic basis of the typical ultrasound features. Kappa statistics were used to assess the consistency between ultrasound findings and histopathological features.

The study comprised 35 patients (mean age, 63 years ±15 [standard deviation], 17 men). In gray-scale sonography, 35 lesions (100%) appeared as hypoechoic areas in the muscle with poorly defined margins. Residual myofiber-like echoes were observed in 25 (71.4%) lesions, and a "cobblestone" appearance was noted in 18 (51.4%). In color-Doppler sonography, 10 (28.6%) patients had intact transverse vessels perpendicular to the long axis of the muscle. In contrast-enhanced sonography, 4 out of 5 (80%) lesions showed synchronous high enhancement. Four out of 5 (80%) lesions exhibited high stiffness on elastography imaging. Myofiber-like echoes (κ: 0.800, P < 0.001) and the "cobblestone" appearance (κ: 0.521, P < .017) are consistent with myofibers in pathology.

Skeletal muscle lymphoma demonstrates specific features on multimodal ultrasound.