The first image demonstrates a hypoechoic, irregularly marginated mass asymmetrically arising from a loop of small bowel. There is also an echogenic linear tract within the described intestinal wall mass representing ultrasound guided tissue sampling with a 16 gauge Tru-cutВ® needle. Within the central portion of the mass, complete loss of bowel wall layering is noted while peripherally, the mass is continuous with a moderately to severely thickened muscularis layer suggesting these changes may represent malignant transformation of chronic inflammatory bowel disease to lymphosarcoma. Image 2: A continuous serosal margin suggests the mass is well contained and the adjacent soft tissue structures, most notably the pancreas are likely uninvolved. Image 3: partial reduction in the hypoechoic mass was noted post chemotherapy consistent with partial remission.