PURPOSE: The diagnosis of cervical lipoma may not always be clinically
apparent, in which case patients are frequently referred for sonograp
hy, The purpose of this study was to document the sonographic features
of head and neck lipomas, METHODS: Twenty-five patients with soft-tis
sue masses in the neck had sonography as their initial imaging study,
A lipoma was suspected on the basis of findings at clinical examinatio
n in only eight of these patients, Lipoma was confirmed by fine-needle
aspiration cytology in 11 patients, by excision biopsy in five patien
ts, by CT in two patients, and by clinical examination with clinical s
onographic follow-up (6 months to 2 years) in seven cases, RESULTS: Li
pomas were well-defined (88%), compressible (100%), elliptical masses
with the longest diameter parallel to the skin surface, All contained
multiple echogenic lines parallel to the skin surface,vith no evidence
of posterior enhancement or attenuation and no flow on color Doppler
sonography, Compared with adjacent muscle, 76% of all lipomas were hyp
erechoic, 8% isoechoic, and 16% hypoechoic, CONCLUSION: The characteri
stic sonographic appearance of head and neck lipomas is that of an ell
iptical mass parallel to the skin surface that is hyperechoic relative
to adjacent muscle and that contains linear echogenic lines at right
angles to the ultrasound beam.