A telemedicine client asked me this question on a recent read so I thought I would share.

A telemedicine client asked me this question on a recent read so I thought I would share.

Client: I could not distinguish is this was LN or intestinal in origin.

See EL: attached IMAGE: Long arrows show the serosa which surrounds the mass. Short arrows show the transition from the recognizable intestinal wall and the mass without the serosa separating it. If the mass were LN you would have both the serosal wall from the intestine and the LN serosa likely fuzzed out from the pinch on grape scenario that lsa ln does bursting at the seams… but still you can make out the separation. Here the intestinal wall is all hypoechoic multiplying like rabbits neoplasia (Note: neoplastic cells have a higher water content than normal cells hence why neoplasia is usually more hypoechoic than normal tissue)….. Leiomyosarcoma does this as well as lsa and other. Great for IOP US and R&A

Color flow Doppler shows the vascularity of the mass but the serosa has to separate the mass from adjacent organs if the the mass doesn’t belong to the organ in question. The echogenic lumen of the intestine is seen in the far field to indicate intestinal origin.