Pseudocalcifications: Radiologic-Pathologic Correlation of Postsurgical Gauze Artifacts

Area of Science:

• Radiology
• Pathology
• Surgical Complications

Background:

• Artifacts and foreign bodies on mammograms can be mistaken for microcalcifications.
• Postsurgical changes at the surgical bed require careful interpretation.

Purpose of the Study:

• To identify and characterize radiodensities in postsurgical mammograms.
• To determine the cause of fine linear radiodensities in the surgical bed.
• To raise awareness of foreign body material as a mimic of microcalcifications.

Main Methods:

• Retrospective review of mammograms from 17 postsurgical women with fine linear radiodensities.
• Histopathological analysis of vacuum-assisted biopsy specimens.
• Ex vivo reproduction of mammographic appearance using chicken breast.
• In vivo study in mice implanted with gauze threads.

Main Results:

• Mammograms revealed fine linear radiodensities in the surgical bed of 17 postsurgical women.
• Histopathology confirmed foreign body material (fragmented gauze) with macrophage reaction.
• Mammographic appearance was reproduced in chicken breast and mice models.
• Identified gauze fragments as the source of the artifact.

Conclusions:

• Fragmented gauze foreign bodies can mimic microcalcifications on mammograms.
• Awareness of this entity is crucial to avoid unnecessary patient examinations and biopsies.
• Postsurgical linear gauze fragments present challenges in mammographic follow-up.