Purpose or Case Report: Cystic liver lesions in the pediatric population are relatively uncommon but encompass a wide range of pathologies. It is important for radiologists to be familiar with the differential diagnosis and imaging characteristics of each entity because prognosis and treatment vary widely. This educational exhibit will review the appearance of various cystic liver lesions in the pediatric population by ultrasound, CT, and MRI and will review clinical presentation and genetic/biologic causes.
Methods & Materials:
Results: Many cystic liver lesions have similar imaging characteristics, but differential diagnoses can be formed by grouping the lesions into congenital, benign neoplasm, malignant neoplasm, infectious/inflammatory, and posttraumatic categories. Congenital lesions include benign developmental hepatic cysts, choledochal cysts, Caroli disease/syndrome, polycystic liver disease, intrahepatic gallbladder, and vascular/lymphatic malformations. Benign neoplastic lesions include mesenchymal hamartoma and biliary hamartoma. Malignant neoplastic lesions include undifferentiated embryomal sarcoma, hepatoblastoma, hepatocellular carcinoma, and cystic metastatic disease. Infectious/inflammatory lesions include pyogenic and amebic abscesses, and echinococcal cysts. Posttraumatic lesions include hematoma and biloma.
Conclusions: Cystic liver lesions are relatively uncommon in the pediatric population, but correct diagnosis is important for the pediatric radiologist as prognosis and treatment vary widely. The different lesions can usually be distinguished with a combination of clinical history, physical exam findings, targeted laboratory evaluation, and imaging characteristics. After reviewing this exhibit, cystic liver lesions can be more easily understood and ultimately diagnosed.