Figure 12a. Xanthogranulomatous oophoritis in a 44-year-old woman. (a) Axial T2-weighted MR image shows a left adnexal mass (white arrows) containing multiple round lesions with high signal intensity (black arrows). (b) Axial T1-weighted MR image shows that the internal lesions have low signal intensity (arrows). (c) Axial contrast-enhanced fat-suppressed T1-weighted MR image shows irregular enhancement of the mass. The nonenhancing lesions (arrows) in the mass correspond to the lesions with high signal intensity on the T2-weighted image (a). An IUD is visible as a nonenhancing area (arrowhead) in the endometrial cavity. (d) Photograph of the pathologic specimen of the mass shows multiple xanthogranulomas (arrows). (e) Photomicrograph (original magnification, x200; hematoxylin-eosin stain) shows multiple lipid-containing foamy histiocytes (arrows).