The Echogenic Echinococcal Cyst

Diagnosis of Infectious Diseases: a Cytopathologist’s Perspective

“…Larval forms, the causative agent of echinococcosis (also known as hydatid dis- ease), invade intestinal walls and gain access to the bloodstream. The organisms come to reside in the liver, creating the radiologic appearance of a single or multilocular cyst (32). It was previously believed that aspiration of presumptive hydatid cysts was exceedingly dangerous due to dissemination of the disease and the potential for anaphylaxis when fluid was released into the surrounding tissue (125,134).…”

Renal Hydatid Cysts and the Evaluation of Their Radiologic Images

“…The mixture of infolded membranes, scolices, and hydatid grains may generate highly echoic solid pat terns which can give tumor-like appearances ( fig. 6a) [2,7,29,38,39,41,44,45], In these cases daughter cysts and/or echoic spiral membranes, and membrane debris should be investigated. Also, the diagnosis of renal hydatidosis should be favored if cystic lesions are present in other organs such as liver, lung and spleen [7,36,39,41], Type V has a rather hyperechoic cyst wall due to the calcified cystic wall and germinative membrane ( fig.…”

“…Although the multivesicular appearance is well rec ognized with US, CT more easily demonstrates calcifica tion which can be a nodular or curvilinear calcification of the cyst wall and daughter cysts ( fig. 4b) [29,44,46,47,50], On CT scan, the presence of daughter cysts within the mother cyst differentiates the lesions from simple renal cysts, renal cystic disease, multiloculated renal masses, renal abscesses, cystic métastasés and necrotic neoplasm [T 50, 51], Echinococcal cysts usually have a homogeneous fluid content showing water attenuation on CT scan. However, these cysts may have high CT values.…”

“…The presence of intracystic debris, hydatid grains and inflammatory cells may cause the high CT values [44,52], Cyst complicated by hemorrhage or infection may have an irregular internal density. Moreover, cysts with dense punctate calcification and calcified daughter cysts may cause a solid, heteroge nous appearance of the echinococcal cyst [29,44,46,50]. The differential diagnosis of such hyperdense masses includes benign entities such as a hyperdense cyst, an infected cyst and primary and secondary solid renal ma lignant neoplasms [51].…”