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November 17, 2024
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Over 50% of patients report having ‘scanxiety’: they experience stress when waiting for the results of medical tests. One of the best ways to reduce that kind of stress is to understand more about the process.
The results of imaging tests contain complex medical terms. One of the terms you might find in your ultrasound results is hypoechoic mass.
This article will explore what a hypoechoic mass is, what it means, what it looks like and how it’s treated.
If your ultrasound report showed a hypoechoic mass, your doctor will discuss the results with you at a follow-up appointment or phone call. For those wanting an early look at their records, PocketHealth provides fast and secure access to your results the moment they are uploaded.
Hypoechoic means an area of tissue on an ultrasound scan that is darker than its surroundings. During an ultrasound scan, the sonographer moves a transducer, which produces high-frequency soundwaves, through conductive gel on the surface of the skin. The sound waves bounce back when they encounter internal structures and tissues, creating echoes which are compiled into live images.
Ultrasound images appear in shades of black, gray and white, depending on the density of the tissues they encounter. A hypoechoic mass does not send back many echoes, so it appears darker gray than the surrounding tissue.
In and of itself, a hypoechoic mass is a nonspecific finding. It does not mean you have cancer, only that the ultrasound has distinguished a concentration of tissue denser than the rest of the immediate area.
In medical terms, echogenic means the ability of internal tissue to reflect or send back an echo on an ultrasound. A tissue’s echogenicity is described as hypoechoic, hyperechoic or anechoic. The chart below shows you the differences between these three terms.
Hypochoic | Hyperechoic | Anechoic |
Does not produce many echoes | Produces many echoes | Produces no echoes at all |
Absorbs more soundwaves | Reflects more soundwaves | Absorbs all soundwaves |
Appears darker gray than surrounding tissue | Appears lighter gray than surrounding tissue | Appears black or much darker than surrounding tissue |
Usually consists of dense, fibrous tissue | May contain air- or fat- filled tissue | Often contains fluid-filled tissue |
Example: Areas of extra-dense breast tissue can look dark gray on an ultrasound | Example: Lung tissue is filled with air, so it appears light gray on an ultrasound | Example: A cyst, a fluid- filled sac, looks black on an ultrasound |
Unsure of what certain medical terms mean in your report? PocketHealth’s Report Reader provides clear definitions to help you understand your results, enabling more informed conversations with your healthcare provider.
Although visibly denser than the tissue around it, a hypoechoic mass does not necessarily indicate disease. An abnormal mass might be a tumor, but not all tumors are malignant (cancerous).
Benign tumors are non-cancerous. Typically composed of the same type of tissue, they have defined borders and are fully contained in one organ. Cysts are masses filled with fluid and are rarely malignant. Potentially malignant tumors tend to have fuzzy, irregular borders, sometimes with branching shapes. Fast-growing, they may invade other organs, be composed of more than one type of tissue or contain calcifications.
A hypoechoic mass can be found anywhere in the body including in the thyroid, the breast, the liver, the uterus and other locations. Here’s a look at some of the body parts where you may find a hypoechoic mass or nodule and what this might indicate.
Ultrasound image of cyst in human thyroid gland
Thyroid nodules are a common occurrence. Ultrasound scans can detect thyroid nodules in up to 67% of the population, though the vast majority are unproblematic. More than 95% of thyroid nodules are benign and do not indicate thyroid cancer. In fact, half of thyroid nodules larger than 1 cm produce no symptoms at all.
If a thyroid nodule causes pain or pressure or interferes with your ability to swallow, treatment may be necessary. Benign hypoechoic thyroid nodules can be solid or fluid-filled, and caused by:
Malignant thyroid nodules are often harder to the touch, and do not move along with the patient as easily, but more testing will be required to determine whether or not a hypoechoic thyroid nodule is benign or malignant.
Ultrasound image showing breast nodules
Breast masses and lesions are very common and do not automatically indicate breast cancer. Breast cysts, which are fluid-filled sacs within the breast tissue, are also a common finding. Many will resolve on their own, after a menstrual cycle. This is why regular mammograms are so important, they establish a baseline from which any change can be measured. Many breast lesions are benign even though they may look irregular on an ultrasound image.
Benign breast lesions can be caused by:
Malignant breast lesions usually have a distinct presentation, with lines radiating from the surface, extended ducts and a shape deeper than it is wide.
Ultrasound of human liver and gall bladder showing gall bladder stones
Liver masses are more common than previously thought. Benign liver lesions occur in almost 15% of the population, but the majority do not produce symptoms, grow or require treatment.
Liver lesions can be cystic (fluid-filled) or solid. The most frequent causes of benign masses are:
Other causes of benign liver lesions are:
Malignant liver masses might be liver metastasis, cancer that has migrated from another part of the body. Other types of liver cancer include strains of:
Ultrasound image of an ovarian cyst
Benign uterine fibroids are normal muscle cells that grow into a mass. They may grow inside or outside the uterus, into the uterine wall or hang from a stalk. These non-cancerous fibroids are extremely common, appearing in up to 80% of women, though only about 20% experience symptoms. Age, ethnicity, diet, family history and obesity all contribute to the potential for fibroids.
Ovarian cysts are another type of hypoechoic mass. Fluid-filled sacs that grow on or inside the ovaries, ovarian cysts are generally benign and often resolve on their own. Most ovarian cysts are caused by hormonal changes during puberty or menopause.
Ultrasound of human kidneys with a renal cyst
Hypoechoic masses can be found in many other parts of the body, such as the:
In each case, the mass itself does not automatically represent disease. Further testing will often be the next step, which might include blood work, further imaging or biopsy.
Ultrasounds make it easy to identify hypoechoic masses, but such a mass does not immediately indicate a serious problem, and not all hypoechoic masses require immediate treatment.
The course of treatment depends on the size and type of the mass, where it was found, whether it was malignant or benign, and whether the patient is experiencing any other symptoms. Some masses resolve on their own and require no intervention. If the mass is caused by infection, it might be solved with medication. Further imaging may also be required.
Not all masses need to be removed. If the mass is very large, malignant, impedes organ function or causes pain, it might require removal, which is often accomplished with laparoscopic surgery for minimal disruption.
If there is any suspicion that a hyperechoic nodule is cancerous, it should be biopsied. If the biopsy indicates cancer, further treatment will be required, which might involve a combination of surgery, radiation and chemotherapy.
Hepatic steatosis, also known as fatty liver, is the buildup of triglycerides in liver cells. Since fat appears lighter on an ultrasound image, a fatty liver is not generally hypoechoic.
Yes, normal lymph nodes can be hypoechoic. Many hypoechoic masses do not require medical treatment or intervention.
PocketHealth gives you fast access to all your medical images and reports in one secure location. You can keep track of your medical imaging records and even share them with specialists in diagnostic quality directly from the platform if you ever want or need a second opinion.
MyCare Navigator flags any follow-up recommendations in your report and provides personalized questions to ask your health care providers, so you can stay empowered and fully in control of your health journey.
