Sonographic features of duodenal lipomas in eight clinicopathologically diagnosed patients

Figure 1 Endoscopic and endoscopic ultrasonography findings in Case 7. A: A submucosal tumors of the descendant duodenum with an intact surface; B: Endoscopic ultrasonography showed a hyperechoic lesion with a distinct anterior border originating from the submucosal layer. There was marked echo attenuation both inside and behind the lesion, and the posterior border was obscure.

Figure 2 Endoscopic and endoscopic ultrasonography findings in Case 8. A: A lobulated submucosal tumor in the descendant duodenum with an ulcer on its surface; B: Endoscopic ultrasonography showed an intensive hyperechoic lesion with a distinct anterior border originating from the submucosal layer without involvement of the overlying mucosal layer. The posterior border of the tumor was invisible because of the marked echo-attenuation.

Figure 3 Endoscopic and endoscopic ultrasonography findings in Case 2. A: A submucosal tumor located in the descendant duodenum with a yellowish and soft appearance; B: Endoscopic ultrasonography showed an oval intensive hyperechoic lesion with homogeneous parenchymal echogenicity and a clear margin originating from the third layer without involvement of the overlying mucosal layers. Echo attenuation was seen at the area behind the focus.

Figure 4 Endoscopic and endoscopic ultrasonography findings in Case 4. A submucosal tumor located in the descendant duodenum. Endoscopic ultrasonography showed a submucosal hyperechoic lesion with marked echo-attenuation behind the focus.

Figure 5 Pathological findings in Case 3. Microscopically, the tumor was located in the submucosa without involvement of the mucosa (HE, × 40).

Figure 6 Pathological findings in Cases 2 and 4. A, B: The tumors consisted of mature fat cells. Abundant fibrous connective tissues were found among the fat cells (HE, × 100).

Figure 7 Pathological findings in Case 7. Massive fiber ropes were inside the tumor parenchyma (HE, × 100).