Hemorrhage into a simple liver cyst: Diagnostic implications of a recent case

Hanazaki, Kazuhiro; Wakabayashi, Masao; Mori, Hiromitsu; Sodeyama, Harutsugu; Yoshizawa, Kazuya; Yokoyama, Shiro; Sode, Yoshihisa; Kawamura, Nobuyuki; Miyazaki, Tatsuya

doi:10.1007/bf02936967

Cited by 47 publications

(30 citation statements)

References 6 publications

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“…Therefore, this discordance between US and CT findings is important for establishing the diagnosis of simple liver cysts associated with intracystic hemorrhage. [5][6][7][8] In recent years, MRI has frequently been used for diagnosing liver disease. In 1993, Vilgrain et al 9 evaluated MRI findings of intracystic hemorrhage in simple liver cysts, and reported that high signals from clot formation detected by T1-weighted sequence were very useful for differentiating blood clot in the cysts from cystic liver tumor exhibiting low signals.…”

Section: Figmentioning

confidence: 99%

Intracystic hemorrhage of a simple liver cyst mimicking a biliary cystadenocarcinoma

Kitajima

Okayama

Hirai

et al. 2003

Journal of Gastroenterology

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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.

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Section: Figmentioning

confidence: 99%

Intracystic hemorrhage of a simple liver cyst mimicking a biliary cystadenocarcinoma

Kitajima

Okayama

Hirai

et al. 2003

Journal of Gastroenterology

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“…They are common and benign, usually asymptomatic, and require no treatment [15,25]. They occasionally resolve spontaneously, but can also cause serious complications [4][5][6][7][8][9][10][11][12][13][14][16][17][18][19][20][21][22][23]26]. Fong et al reviewed the literature on hemorrhagic hepatic cysts [27].…”

Section: Discussionmentioning

confidence: 99%

“…Cytologic examination of cystic fluid obtained by aspiration may provide important information for distinguishing malignant from benign lesions [11]. However, aspiration of a cystic lesion can lead to tumor spread.…”

Section: Discussionmentioning

confidence: 99%

“…Most benign, nonparasitic hepatic cysts are found incidentally and are usually asymptomatic. However, complications such as obstructive jaundice [4], rupture [5][6][7][8][9], intracystic hemorrhage [9][10][11][12][13][14][15], and infection [16][17][18][19][20][21][22][23][24] can occasionally occur. Most patients with a hemorrhagic hepatic cyst present with abdominal pain (80%), while some cases are asymptomatic at the time of presentation [15].…”

Section: Introductionmentioning

confidence: 99%

“…Even when diagnosed accurately, the optimal treatment strategy remains controversial. Hepatectomy is usually performed in this situation [9,11].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

An Asymptomatic Hemorrhagic Hepatic Cyst with Solid Contents

Kondo¹,

Yoshida²,

Hirakata³

et al. 2014

Int J Gastroenterol Disord Ther

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We describe a patient who had an asymptomatic hemorrhagic hepatic cyst with solid contents that mimicked a malignancy. An 85-year-old woman was referred to our hospital because a hypoechoic mass was detected. She had no complications. The past medical history included hypertension and left femoral artery aneurysm. The results of initial laboratory tests were as follows: serum aspartate aminotransferase, 28 IU/L; serum alanine aminotransferase, 23 IU/L; serum C-reactive protein, 0.11 mg/dL; and serum hemoglobin concentration, 13.1 g/dL. The serum platelet count (17.3×104/μL) was slightly decreased. The serum concentration of carcinoembryonic antigen was 3.0 ng/mL, that of CA19-9 was 12.2 u/ml, and that of AFP was 3.8 ng/ml. The serum concentration of hyaluronic acid (147 ng/mL) was elevated. Hepatitis B virus antigen and hepatitis C virus antibody were negative. Ultrasonography revealed a protruding hypoechoic mass, 6 cm in diameter, with a central isoechoic structure in segment 7, accompanied by multiple hepatic cysts. The edge of the liver was dull, and the liver parenchymal echo was mildly rough. Computed tomography (CT) showed a slightly high-density area with calcification of the margin. Magnetic resonance imaging revealed a hypointense lesion with central hyperintensity on T1-weighted sequences and hyperintensity on T2-weighted sequences. On positron emission tomography-CT, there was no uptake of fluorodeoxyglucose in the liver. We diagnosed an old hemorrhagic cyst or abscess, but could not rule out a malignant neoplasm because of the damaged liver. A right lateral sectionectomy was therefore performed. The resected specimen had black solid contents, and the capsule lacked fluid. Pathological examination revealed an old hemorrhage with a thick fibrous capsule without epithelial components. The liver showed mild fibrosis with fatty changes. The lesion was considered an old hemorrhagic hepatic cyst because a nearby hepatic cyst had simple columnar epithelium.

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Infected liver cysts resulting from ascending cholangitis and cancer of the ampulla of Vater: A case report

Hsu

Tsai

Chen

et al. 2021

Adv in Digestive Medicine

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Infected liver cysts may have a unique etiology and require further workup. Generally, large cyst is easy to be symptomatic. In contrast, smaller cyst with infection in our case is associated with ampullar cancer of Vater without typical manifestations of jaundice, body weight loss, and pancreatitis. We presented the case of a 61‐year‐old man with infected liver cysts, which is confirmed by abdominal computer tomography and liver cysts drainage with bacterial culture. Endoscopic retrograde cholangiopancreatography revealed a swollen papilla of Vater and a dilated common bile duct. Biopsy confirmed adenocarcinoma of the ampulla of Vater. Further surgical pathology revealed communication of bile duct with liver cysts and no evidence of tumor invasion to pancreatic duct and common bile duct. The infected liver cysts may result from ascending cholangitis which is secondary to ampullar cancer. The patient underwent the Whipple procedure, unroofing of the right‐side liver cyst, and partial hepatectomy without complications. There is no recurrence of infected liver cyst and cancer till now after follow‐up for 3 years. Infected liver cysts are rarely associated with ampullar cancer. Early diagnosis and successful resection of early stage ampullary neoplasm ensure favorable outcomes.

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Hemorrhage into a simple liver cyst: Diagnostic implications of a recent case

Cited by 47 publications

References 6 publications

Intracystic hemorrhage of a simple liver cyst mimicking a biliary cystadenocarcinoma

Intracystic hemorrhage of a simple liver cyst mimicking a biliary cystadenocarcinoma

An Asymptomatic Hemorrhagic Hepatic Cyst with Solid Contents

Infected liver cysts resulting from ascending cholangitis and cancer of the ampulla of Vater: A case report

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