Differential Diagnosis of Hypoechoic Lesion in Left Iliac Fossa

Primary Diagnostic Considerations

Colonic lymphoma can present as a hypoechoic mass in the bowel wall, according to the American Gastroenterological Association 1
Metastatic disease to peritoneum or lymph nodes can appear hypoechoic, as stated by the American Gastroenterological Association 1, 2

Location and layer of origin (bowel wall, peritoneal, retroperitoneal, gynecological) should be assessed, as recommended by the European Society of Radiology 3
Internal characteristics (solid vs cystic, presence of septations, debris, or daughter cysts) should be evaluated, according to the European Society of Radiology 3
Size, shape, and border characteristics (well-circumscribed vs infiltrative) should be considered, as stated by the European Society of Radiology 3
Vascularity on Doppler examination helps differentiate inflammatory from neoplastic processes, as recommended by the American Institute of Ultrasound in Medicine 4

Hypoechoic lesions require tissue sampling when malignancy is suspected, as hypoechogenicity alone is not diagnostic, according to the European Society of Radiology 3