What pathology is indicated by the "string of pearls" appearance?

The "string of pearls" appearance is typically associated with ovarian hyperstimulation syndrome or the presence of multiple small cysts in the ovaries. This term describes the ultrasound finding where numerous small, anechoic cysts are visualized along the periphery of an enlarged ovary. The cysts can look like a string of pearls due to their arrangement and size, reflecting the hormonal stimulation of the ovaries, often as a result of fertility treatments.

This appearance is clinically significant as it helps to differentiate ovarian hyperstimulation syndrome from other ovarian pathologies. In contrast, hepatic steatosis, renal cell carcinoma, and simple liver cysts do not present with the specific ultrasound characteristics that match the "string of pearls" description. Instead, those conditions are characterized by different sonographic findings, such as increased echogenicity in hepatic steatosis, complex masses in renal cell carcinoma, and solitary or multiple well-defined cysts in the case of simple liver cysts. Thus, recognizing the "string of pearls" appearance is crucial for diagnosing and managing cases related to ovarian conditions.