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Sonographic Appearance of Steatocystoma: An Analysis of 14 Pathologically Confirmed Lesions

지선낭종의 초음파 소견: 조직학적으로 진단된 14개 병변의 분석

  • Hyeyoung Yoon (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Yusuhn Kang (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Hwiryong Park (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Joong Mo Ahn (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Eugene Lee (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Joon Woo Lee (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Heung Sik Kang (Department of Radiology, Seoul National University Bundang Hospital)
  • 윤혜영 (분당서울대학교병원 영상의학과) ;
  • 강유선 (분당서울대학교병원 영상의학과) ;
  • 박휘룡 (분당서울대학교병원 영상의학과) ;
  • 안중모 (분당서울대학교병원 영상의학과) ;
  • 이영준 (분당서울대학교병원 영상의학과) ;
  • 이준우 (분당서울대학교병원 영상의학과) ;
  • 강흥식 (분당서울대학교병원 영상의학과)
  • Received : 2019.12.21
  • Accepted : 2020.06.11
  • Published : 2021.03.01

Abstract

Purpose To evaluate the ultrasonographic characteristics of steatocystomas focusing on the features that aid in differentiating them from epidermal inclusion cysts and lipomas. Materials and Methods The ultrasonographic findings of 14 histologically proven steatocystomas in 10 patients were retrospectively reviewed. The following features were assessed: the layer of involvement, shape, margin, echogenicity, posterior acoustic features, and the presence of a visible wall or intralesional striations. The findings were compared with those of subcutaneous lipomas and epidermal inclusion cysts to identify those findings that aid in the differential diagnosis of steatocystomas. Results The majority of steatocystomas appeared as a subcutaneous mass (n = 6, 42.9%) or a mass involving both the dermal and subcutaneous layers (n = 6, 42.9%). Steatocystomas exhibited a well-defined smooth margin (n = 12, 85.7%) and homogeneous echogenicity (n = 9, 64.3%), and showed no specific posterior acoustic features (n = 9, 64.3%). The most important features that differentiated steatocystomas from epidermal inclusion cysts were a homogeneous internal echotexture (p = 0.009) and absent or less prominent posterior acoustic enhancement (p < 0.001). The features that distinguished steatocystomas from lipomas were the margin (p < 0.001), echogenicity (p = 0.034), internal echotexture (p = 0.004), and the absence of intralesional striations (p < 0.001). Conclusion Steatocystomas appeared as well-defined homogeneous masses with mild or absent posterior acoustic enhancement.

목적 지선낭종의 초음파 소견을 분석하고, 표피낭종 및 지방종과의 감별진단에 도움이 되는 소견을 알아보고자 하였다. 대상과 방법 10명의 환자에서 14개의 조직학적으로 확진된 지선낭종의 초음파 소견을 후향적으로 검토하였다. 병변의 위치, 모양, 경계, 에코 발생 정도, 후방 음향 특징 및 테두리 벽 또는 병변 내 줄무늬의 존재 여부를 평가하였다. 지선낭종의 초음파 소견을 분석하고, 표피낭종 및 지방종과의 감별진단에 도움이 되는 소견을 알아보고자 하였다. 결과 지선낭종의 대부분은 피하 종괴(n = 6, 42.9%) 또는 피부층과 피하층을 함께 침범한 종괴로(n = 6, 42.9%) 나타났다. 병변은 대부분 경계가 잘 지어지고(n = 12, 85.7%) 균질한 에코 발생을 보였으며(n = 9, 64.3%), 후방 음향 특징을 나타내지 않았다(n = 9, 64.3%). 표피낭종을 지선낭종과 구별하는 가장 중요한 소견은 균질한 내부 에코 발생과(p = 0.009), 현저하지 않은 후방 음향 향상이다(p < 0.001). 지선낭종과 지방종의 구별되는 특징은 경계(p < 0.001), 에코 발생성(p = 0.034), 내부 에코 성상(p = 0.004) 및 병변 내 줄무늬의 부재였다(p < 0.001). 결론 지선낭종은 초음파 검사상 경계가 좋고 균질하며, 후방 음향 향상이 경도로 있거나 없는 종괴로 관찰되었다.

Keywords

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