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To the Editor.—
We agree in principle with Cardello et al (227:1124, 1974) that great care must be taken in the diagnosis of fluid-filled masses with ultrasound B scan. A-mode simultaneous evaluation was carried out in our previously reported case (226:82, 1973) but not reported in the article. We have also discovered that acoustically homogeneous lesions can be extremely difficult to differentiate from cystic lesions. We had a case of a herniated left lobe of the liver presenting as a left hilar mass that was quite difficult to separate from a cystic lesion on ultrasound.Several points should be made with regard to their reported case. Close clinical and radiographic correlation is mandatory in the evaluation of mediastinal mass lesions with ultrasound. As illustrated in their case, any mass presenting with associated mediastinal widening or paratracheal adenopathy should be considered a solid tumor until proven otherwise. As Cardello et al
Crummy AB, Friday RO. Ultrasound Tumor Diagnosis. JAMA. 1974;228(8):975. doi:10.1001/jama.1974.03230330017005