Incidental whole-body MRI evidence of COVID-19 in an asymptomatic patient in a high prevalence region

Angelini, Valentina; Villanacci, Alberta; Belotti, Angelo; Castagnoli, Francesca; Frittoli, Barbara; Corvino, Antonio; Brunetti, Arturo; Grazioli, Luigi

ABSTRACT: BACKGROUND: The purpose of this case report is to emphasize the importance of curing any clinical radiological elements in this historical period, especially in the area of endemic to coronavirus disease 19 (COVID-19) such as Lombardy and to stress the importance of the management of the asymptomatic patient, their crucial role in the spread of contagion. CASE PRESENTATION: We reported the case of incidental diagnosis of interstitial pneumonia by first finding on whole-body MR (WB-MR) in the patient affected by multiple myeloma (MM), with a negative respiratory symptoms at the time and with previous (1 month before) negative chest X-ray. The patient was promptly subjected to chest CT, which confirmed the suspicion of interstitial COVID-19 pneumonia and, in hospitalization, performed nasopharyngeal swabs for real-time polymerase chain reaction (RNA-PCR), with a doubtful outcome. Once the bacterial nature of the alterations was serologically and radiologically excluded, the patient was definitively diagnosed with COVID-19 and appropriately treated in hospitalization. CONCLUSION: The clinical choices must, therefore, to make use of all the diagnostic tools available and full knowledge of the limitation of each of them.