• Livid, localized nodular swelling
• An infected varix is hard, extremely tender, and surrounded by erythematous skin.
n Diagnosis: compression sonography of the veins of the lower extremity; conventional venography is rarely necessary (see p. 212). n Sonographic findings:
• Easily compressible, anechoic nodule
• CDS demonstrates blood flow. A normal flow velocity excludes thrombosis and an arteriovenous fistula (following left-heart catheterization or dilatation therapy).
n Accuracy of sonographic diagnosis: A varix located close to the transducer can be positively identified.
E o n Clinical manifestations: swelling, no systemic manifestations n Diagnosis:
• Palpation: doughy, mobile, nontender
• Gradual enlargement may occur; doubts are resolved by FNAB.
Round or elliptical mass n Sonographic findings: ^
• Smooth, well-defined margins
• Hypoechoic rim may form as a result of tumor expansion "jj
• Lipoma tends to be echogenic. ¡j» n Accuracy of sonographic diagnosis: Sonography can clearly demonstrate the individual features of these tumors, but it is prudent to evaluate the lesion by FNAB. If the findings are equivocal, a local excision is indicated.
Fig. 142 Lipoma (cursors): rubbery, mobile mass that is hyperechoic to the neck muscles (M)
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