Diagnostic Accuracy of Ultrasonography in Superficial Soft Tissue Masses: A Clinicopathological Correlation Study

Vijai Raj Saxena; Ajay Kumar Singh; Muskan Singh; Ruchika Singh; SK Singh; Aman Kumar

doi:10.15850/ijihs.v14n1.4802

Authors

Vijai Raj Saxena Department of Radiodiagnosis, KNS Memorial Institute of Medical Science (KNS MIMS), Uttar Pradesh, India
Ajay Kumar Singh Department of Radiodiagnosis, KNS Memorial Institute of Medical Science (KNS MIMS), Uttar Pradesh, India
Muskan Singh Department of Radiodiagnosis, KNS Memorial Institute of Medical Science (KNS MIMS), Uttar Pradesh, India
Ruchika Singh Department of Radiodiagnosis, KNS Memorial Institute of Medical Science (KNS MIMS), Uttar Pradesh, India
SK Singh Department of Radiodiagnosis, KNS Memorial Institute of Medical Science (KNS MIMS), Uttar Pradesh, India
Aman Kumar Department of Radiodiagnosis, KNS Memorial Institute of Medical Science (KNS MIMS), Uttar Pradesh, India

DOI:

https://doi.org/10.15850/ijihs.v14n1.4802

Keywords:

Biopsy, Epidermoid Cyst, Limpoma, Soft Tissue Neoplasms, Ultrasonography

Abstract

Background: Superficial soft tissue swellings are a common and diagnostically heterogeneous presentation in dermatology outpatient practice. High-resolution ultrasonography (USG) is widely used as a first-line adjunct to distinguish cystic from solid lesions, define anatomic planes, and triage for reassurance, drainage, excision, or biopsy.

Objective: To evaluate the diagnostic accuracy of USG for superficial swellings using histopathology as the reference standard.

Methods: A retrospective clinicopathological correlation study was conducted at a tertiary care teaching hospital under a collaboration between Dermatology and Radiodiagnosis departments. USG impressions (grey scale ± color Doppler) were correlated with final histopathological diagnoses. Primary diagnostic performance was assessed for malignant/suspicious versus benign lesions using 2×2 contingency tables to compute sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results: Most participants were 31–40 years old (26.7%); males comprised 56.7%. Upper limb lesions were most frequent (30.0%), followed by head and neck (23.3%). Histopathology showed predominantly benign disease (58/60; 96.7%), most commonly lipoma (30.0%) and epidermoid cyst (23.3%). Malignancy was rare (2/60; 3.3%; Dermatofibrosarcoma protuberans and liposarcoma). USG classified 57 lesions as benign and three as malignant/suspicious. USG demonstrated 100% sensitivity (TP=2, FN=0), 98.3% specificity (TN=57, FP=1), 66.7% PPV, and 100% NPV for differentiating Benign from Malignant lesions.

Conclusion: High-resolution ultrasonography showed excellent performance for ruling out malignancy in superficial soft tissue swellings, with perfect sensitivity and NPV, and very high specificity. In dermatology outpatient department (OPD) pathways, USG is a valuable first-line tool for risk stratification and procedural planning, with occasional cautious overcalling in low-prevalence malignancy settings.