Differentiation of Borderline Epithelial Ovarian Tumors from Benign and Malignant Epithelial Ovarian Tumors by MRI Scoring

INTRODUCTION: The distinction between benign and borderline epithelial ovarian tumors is important because treatment and follow-up strategies differ OBJECTIVE: We aimed to evaluate benign, borderline, and malignant epithelial ovarian tumors using MRI features and contributed to the preoperative evaluation. METHODS: MRIs of 81 patients (20 bilateral), including 31 benign, 27 borderline, and 23 malignant, who had pelvic imaging between 2013-2020, were evaluated retrospectively. The evaluation was made blindly to the pathology result by two radiologists with MRI scoring and features that we determined. MRI evaluation was performed with T1 TSE, T2 TSE, fat-suppressed T2 TSE, and before and after contrast T1 fat-suppressed and non-fat-suppressed TSE images. The numbers and findings obtained in scoring were evaluated by Chi-Square, ordinal logistic regression, and 2 and 3 category ROC analysis. RESULTS: The total score varied between 7 and 24. Among the three groups, a significant difference was found in terms of T1, T2 signal intensity (p <0.01), size (p = 0.055), solid area (p <0.001), septa number (p <0.05), ovarian parenchyma (p = 0.001), ascites (p <0.001), peritoneal involvement (p <0.001), laterality (p <0.001), contrast enhancement pattern (p <0.001). On the other hand, no significant difference was found in terms of wall thickness, lymph node involvement and endometrial thickness (p> 0.05). Cut-off values were found as 11.5 and 18.5 in the 3-category ROC analysis performed for the score (VUS: 0.8109). Patients with a score below 11.5 were classified as benign, those between 11.5-18.5 as borderline, and those over 18.5 as malignant. CONCLUSION: The differentiation of borderline tumors from benign and malignant tumors by MRI scoring will contribute to the preoperative diagnosis.

COVID-19 Pneumonia Presenting with Multiple Nodules Mimicking Metastases: An Atypical Case.

Coronavirus disease 2019 (COVID-19) is an outbreak causing pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and computed tomography (CT) images are a significant part of the diagnosis of COVID-19 related pneumonia. Typical chest CT findings are bilateral peripheral ground-glass opacities (GGO) with or without consolidation. Although rare, atypical CT findings have been described, no case of COVID-19 causing multiple solid pulmonary nodules has been reported. In this article, atypical CT findings of a 45-year-old female patient with multiple solid pulmonary nodules mimicking metastasis diagnosed with COVID-19 confirmed by reverse transcription polymerase chain reaction (RT-PCR). Teaching point: COVID-19 pneumonia may mimic multiple metastatic nodules radiologically.

Imaging Features of Breast Plasmacytoma.

Extramedullary plasmacytoma (EMP) occurs as a result of abnormal proliferation of plasma cells outside the bone marrow. Breast plasmacytomas are rare. Radiologically, they can be confused with benign and malignant lesions of the breast. It is important to be able to diagnose EMP in the breast since the treatment strategy is different from that of other lesions and allows for the diagnosis and early treatment of multiple myeloma (MM) relapse. We report imaging and clinicopathological findings of an EMP case in which a 65-year-old patient with MM in remission presented with breast masses.