Wednesday, June 6, 2012

Cystic Hepatic Lesion: Differential Diagnosis #23

The Daily Diff for today relates to a common finding: a low density liver lesion representing a cyst. While the majority of these will be simple, benign cysts, being able to differentiate the other possible entities is worthwhile. Sorry, no mnemonic here, but here are the other possibilities:

DiseaseNotes

Simple hepatic cystmost common (up to 10% of population

Pyogenic cystthickened enhancing wall; gas present (20%); septic patient

Amebic cystsolitary; right lobe; enhancing thickened wall *and* surrounding parenchyma (double-rim target appearance)

Hydatid cystcaused by Echinococcus; thickened wall with calcifications; layering debris (hydatid sand); often multilocular with daughter cysts (spokewheel appearance)

Simple hepatic cyst (they can be huge!)
Source: Radiopaedia
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