Lung ultrasound in the COVID-19 era: a lesson to be learned for the future.

Lung Ultrasound (LUS) is a reliable, radiation free and bedside imaging technique to assess several pulmonary diseases. Although the diagnosis of COVID-19 is made with the nasopharyngeal swab, detection of pulmonary involvement is key for a safe patient management. LUS is a valid alternative to explore, in paucisymptomatic self-presenting patients, the presence and extension of pneumonia compared to High Resolution Computed Tomography (HRCT) that represent the gold standard. This is a single-centre prospective study with 131 patients enrolled. Twelve lung areas were explored reporting a semiquantitative assessment to obtain the LUS score. Each patient performed reverse-transcription polymerase chain reaction test (rRT-PCR), hemogasanalysis and HRCT. We observed an inverse correlation between LUSs and pO2, P/F, SpO2, AaDO2 (p value < 0.01), a direct correlation with LUSs and AaDO2 (p value < 0.01). Compared with HRCT, LUS showed sensitivity and specificity of 81.8% and 55.4%, respectively, and VPN 75%, VPP 65%. Therefore, LUS can represent an effective alternative tool to detect pulmonary involvement in COVID-19 compared to HRCT.

CT imaging of an unusual malignant inguinal mass: metastatic parafunicular dedifferentiated liposarcoma.

A man in his 50s was redirected by his general practitioner to our University Hospital for a radiological evaluation after the complaint of a left inguinal swelling. The preliminary ultrasound and CT scan showed a left parafunicolar mass located between the root of the penis and the spermatic cord. The lesion was biopsied shortly after and histologically diagnosed as a dedifferentiated liposarcoma. The patient underwent a cycle of neoadjuvant radiotherapy, which proved to be ineffective. He was then subjected to an organ sparing surgical removal of the mass, followed by a second organ sparing removal of some residual disease. The last CT scan showed absence of the inguinal disease; however, lung and hepatic metastasis were detected, which are scheduled to be treated with a course of chemotherapy and radiofrequency.