Intracystic hemorrhage of a simple liver cyst mimicking a biliary cystadenocarcinoma |
| |
Authors: | Kitajima Yasuhiro Okayama Yasutaka Hirai Masaaki Hayashi Kazuki Imai Hideto Okamoto Tetsu Aoki Shigeru Akita Shinji Gotoh Kazuo Ohara Hirotaka Nomura Tomoyuki Joh Takashi Yokoyama Yoshifumi Itoh Makoto |
| |
Institution: | (1) Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, 5-161 Maehatacho, Tajimi 507-8522, Japan, JP;(2) The First Department of Internal Medicine, Nagoya City University Medical School, Nagoya, Japan, JP |
| |
Abstract: | Simple liver cysts are rarely complicated by intracystic hemorrhage. We encountered a case of simple liver cyst that was morphologically
similar to biliary cystadenocarcinoma, which was complicated by asymptomatic intracystic hemorrhage and successfully treated
by right lobectomy. A large cystic lesion of the liver was detected in a 57-year-old woman during a mass screening health
check. Abdominal ultrasonography (US) revealed that the cystic lesion, containing many hyperechoic papillary structures, occupied
almost the entire region of the right hepatic lobe. In addition, a round mural nodule, measuring approximately 5 cm in diameter,
was detected in the cystic wall. Abdominal computed tomography (CT) revealed that the inner part of the cystic lesion showed
homogeneous low density, but CT did not show the round nodule detected by US. On T1-weighted sequence of magnetic resonance
imaging (MRI), the lesion showed homogeneous high signals, together with a low-signal tumorous lesion in the cystic wall.
T2-weighted sequence of MRI showed unhomogeneous high signals, together with high signals in the tumorous part. These findings
did not exclude the possibility of a malignant cystic tumor, such as biliary cystadenocarcinoma. Therefore, right lobectomy
was performed. Histological examinations of resected tissue specimens revealed that the lesion was a liver cyst containing
a large amount of blood clot, and that the tumorous lesion detected by US and MRI was a large mass of blood clot which was
partly liquefied. This case indicates the diagnostic importance of the morphological discordance between CT and US or MRI
findings for liver cyst containing a large amount of blood clot.
Received: May 7, 2001 / Accepted: December 27, 2001
Reprint requests to: Y. Kitajima |
| |
Keywords: | : intracystic hemorrhage liver cyst MRI |
本文献已被 PubMed SpringerLink 等数据库收录! |
|