Small Echogenic Foci in the Ovaries

Douglas L Brown, Mary C Frates, Michael G Muto, William R Welch
Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2004 · vol. 23(2) , pp. 307–313 · doi:10.7863/jum.2004.23.2.307 · PMID:14992370 · W1748673661
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Small echogenic ovarian foci are most often hemosiderin or calcification and are associated with benign histologic findings, not reliably indicating endometriosis or endosalpingiosis.

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Abstract

OBJECTIVE: The purpose of this study was to determine the histologic correlate of small echogenic foci in the ovary and to assess for any association with endometriosis or endosalpingiosis. METHODS: Women planning to have a normal ovary surgically removed were scanned preoperatively with transvaginal sonography. If echogenic foci were present in either normal ovary on the preoperative scan, the removed ovary was scanned in a saline bath, and the surface was marked with india ink over an echogenic focus. Histologic sections were then obtained at the marked site. RESULTS: Echogenic foci were detected in 23 ovaries of 16 women. Possible causes were found in 17 of the 23 ovaries: hemosiderin in 6 cases, calcification in 5 cases, hemosiderin and calcification in 2 cases, clusters of inclusion cysts in 2 cases, 1 of which also had hemosiderin, and dense cortical nodules in 2 cases. Histologic findings were benign in all cases except in 1 patient who had primary peritoneal carcinoma unrelated to the echogenic foci. One ovary in another patient had both endosalpingiosis and endometriosis. One other patient had endometriosis involving a fallopian tube but not the ovary. There were no other cases of endometriosis or endosalpingiosis. CONCLUSIONS: Small echogenic foci in the ovaries are most frequently due to hemosiderin or calcification. A few small echogenic foci in the ovaries are associated with benign histologic changes and do not appear to be reliable indicators of endosalpingiosis or endometriosis.

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Condition tags

endometriosis

MeSH descriptors

Ovarian Diseases Ultrasonography Adult Aged Aged, 80 and over Female Humans Middle Aged Ovarian Diseases Ovarian Diseases Ovarian Diseases Prospective Studies Ultrasonography Vagina

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