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hepatic cyst
Epidemiology:
- among the most common incidental findings on abdominal imaging
Pathology:
- the majority of hepatic cysts are benign
Clinical manifestations:
- generally asymptomatic
- symptoms should raise suspicion for biliary cystadenoma
Laboratory:
- cystic fluid analysis
- cystic fluid CA19-9
- cystic fluid carcinoembryonic antigen
- not helpful in distinguishing simple haptic cyst from biliary cystadenoma [2]
Special laboratory:
- abdominal ultrasound
- septation, & wall irregularities raise suspicion of biliary cystadenoma or biliary cystadenocarcinoma
Differential diagnosis:
- biliary cystadenoma (premalignant)
- more common in women, cysts with a septum & cysts with septal thickening [2]
- biliary cystadenocarcinoma
Management:
- observation
- asymptomatic hepatic cysts do not require follow-up [1]
- surgical excision if suspicion of biliary cystadenoma or biliary cystadenocarcinoma [1]
Related
hepatic abscess
hepatoma
General
cyst
liver disease
References
- Medical Knowledge Self Assessment Program (MKSAP) 16, 18, 19.
American College of Physicians, Philadelphia 2012, 2018, 2021.
- Choi HK, Lee JK, Lee KH et al
Differential diagnosis for intrahepatic biliary cystadenoma
and hepatic simple cyst: significance of cystic fluid analysis
and radiologic findings.
J Clin Gastroenterol. 2010 Apr;44(4):289-93.
PMID: 19770676