Imaging Pearls ❯ Liver ❯ Cysts of the liver
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- Biliary Cystadenoma/Cystadenocarcinoma
- Cystic lesion with multiple internal loculations
- Encapsulated and well circumscribed
- Even if benign, can have malignant potential
- Very difficult to completely resect
- Female predominance
- “ The spectrum of multilocular cystic hepatic lesions includes common and uncommon entities. A lesions cystic component and internal septa usually reflect its underlying pathologic basis, although imaging findings are not always specific.”
Spectrum of Multilocular Cystic Hepatic Lesions: CT and MR Imaging Findings with Pathologic Correlation
Qian LJ et al.
RadioGraphics 2013;33:1419-1433 - Multilocular Cystic Hepatic Masses: Differential Dx
- Biliary Cystadenoma and cystadenocarcinoma
- Hepatoma
- Metastases
- Mesenchymal hamartoma
- Inflammatory myofibroblastic tumor - Multilocular Cystic Hepatic Masses: Differential Dx
- Hepatic abscess
- Echinococcal cyst
- Intrahepatic hematoma
- Biloma
- Polycystic liver disease - Biliary Cystadenoma and Cystadenocarcinoma: facts
- Usually in middle aged female patients
- Biliary Cystadenoma may transform into a biliary cystadenocarcinoma and so all are resected
- CT findings include a large, solitary, multilocular cystic lesion with well circumscribed smooth margins and internal septa
- Enhancement and/or calcification may occur in cyst wall
- Hepatic Cyst
1. Simple water attenuation lesions
- Be suspicious of solid nodularity or thick septations
- Some complexity is not uncommon
2. Usually congenital as a result of an abnormality in bile duct formation
3. Polycystic Liver Disease