Hepatic cyst

Hepatic cyst

Description

Hepatic cysts are thought to arise from canalicular maldevelopment, and are rare. The lining of the cyst usually comprises cuboidal or columnar epithelium. The cyst can potentially be large enough to cause respiratory embarrassment following delivery.

Diagnosis

The cyst will appear in the right upper quadrant more frequently than the left. It should be possible to see that it is located within the structure of the liver, distinct from surrounding organs.

Differential Diagnosis

Other intraabdominal cysts include those arising from surrounding structures: Renal tract abnormalities include hydronephrosis in which the ‘cyst’ is clearly located within the kidney; multicystic dysplastic kidneys, where there are usually multiple cysts; obstructed, dilated bladders which will arise from the pelvis. The adrenal gland is a rare site for cyst formation (simple cysts, neuroblastoma), but its location immediately above the kidney should be diagnostic. Gastrointestinal ‘cysts’ include bowel reduplication; the location of these may not be fixed. Choledochal cysts are found on the right side. Splenic cysts are located within the spleen in the left upper quadrant. Pancreatic cysts lie behind the stomach. Ovarian cysts will usually be seen to arise from the pelvis.

Sonographic Features

Unilocular cyst within the structure of the liver, usually within the right lobe

No blood flow within the cyst with Doppler

Associated Syndromes

  • Ellis-van Creveld disease
  • Short rib-polydactyly syndrome type 11 (Majewski)
  • Adult polycystic kidney disease
  • Infantile polycystic kidney disease
  • Ivemark
  • Meckel-Gruber

References

Chung WM Antenatal detection of hepatic cyst J Clin Ultrasound 14: 217-219