This case of actinomycosis in the tongue presented a lesion that appeared as a well-defined hypoechoic mass. Ultrasonographic
examination showed a dotlike hyperecho in the center of the mass, and Color Doppler imaging showed rich flow signals in it.
Pathologic findings confirmed that the hyperechoic structure in the central part of the tongue was composed of sulphur granules
deriving from actinomyces infections and indicated that the rich flow signals were the result of inflammatory reactive vessels.
These findings suggest that a central dotlike hyperecho (sulphur granule) may be characteristic of actinomycosis.