Small echogenic foci in the ovaries: correlation with histologic findings

Brown DL, Douglas L. Brown, Frates MC, Mary C. Frates, Michael G Muto, Muto MG, Welch WR, 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 Adult Aged Aged Aged, 80 and over Aged, 80 and over Female Female Humans Humans Middle Aged Middle Aged Ovarian Diseases Ovarian Diseases Ovarian Diseases Ovarian Diseases Prospective Studies Prospective Studies

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