DOI: 10.1148/rg.243035173
Echinococcal Cyst1
Stefania Proietti, MD,
Amina Abdelmoumene, MD,
Muriel Genevay, MD and
Alban Denys, MD
1 From the Departments of Radiology (S.P., A.A., A.D.) and Pathology (M.G.), Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Received July 28, 2003; revision requested August 28 and received October 8; accepted November 7. Address correspondence to S.P., Department of Radiology, Prof Grenier University Hospital, La Pitié-Salpetrière, 105 boulevard de l’Hôpital, 75013 Paris, France (e-mail: sproietti@hotmail.com).
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Figure 1a. (a) Abdominal CT scan obtained before administration of contrast material shows a large multilocular mass in the liver. The mass consists of multiple small hypoattenuating cysts. Thin eggshell calcifications can be seen within the cyst walls (arrows). The bile ducts of segments II and III are dilated. (b) Abdominal CT scan obtained after administration of contrast material shows the mass. Multiple cysts are seen in the right subhepatic space (arrow). They appear to be subserosal because of the mass effect they produce on the adjacent hepatic parenchyma.
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Figure 1b. (a) Abdominal CT scan obtained before administration of contrast material shows a large multilocular mass in the liver. The mass consists of multiple small hypoattenuating cysts. Thin eggshell calcifications can be seen within the cyst walls (arrows). The bile ducts of segments II and III are dilated. (b) Abdominal CT scan obtained after administration of contrast material shows the mass. Multiple cysts are seen in the right subhepatic space (arrow). They appear to be subserosal because of the mass effect they produce on the adjacent hepatic parenchyma.
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Figure 2a. (a) Axial T1-weighted MR image shows the mass, which is well defined, smooth, thin walled, multilocular, and cystic and involves segments IV, VII, and VIII. The cysts are hypointense. (b) Axial T2-weighted MR image shows extrahepatic cysts along the gastrohepatic ligament (arrow). The cysts are hyperintense.
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Figure 2b. (a) Axial T1-weighted MR image shows the mass, which is well defined, smooth, thin walled, multilocular, and cystic and involves segments IV, VII, and VIII. The cysts are hypointense. (b) Axial T2-weighted MR image shows extrahepatic cysts along the gastrohepatic ligament (arrow). The cysts are hyperintense.
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Figure 3. Photograph of the gross specimen shows an irregular cystic lesion, which has been enucleated and seems to be well demarcated.
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Figure 4. Photograph of the bisected mass shows good correlation with the US and CT appearances. The lesion has an alveolar structure composed of numerous irregular cysts. Note the focal calcifications (arrows).
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Figure 5. Photomicrograph (original magnification, x4; hematoxylin-eosin stain) shows the infiltrative border between the lesion and the adjacent hepatic parenchyma (arrow). This appearance is unlike that of lesions due to E granulosus.
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Figure 6. Photomicrograph (original magnification, x10; hematoxylin-eosin stain) shows multiple cysts separated by dense, hyaline, fibrous tissue. Note the laminated membrane in the inner part of the cysts (arrows), which is avascular, refractile, and chitinous.
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Figure 7. Photomicrograph (original magnification, x20; hematoxylin-eosin stain) shows the contents of the cysts. Multiple protoscolices of E multilocularis (arrows) are seen within daughter cysts.
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Copyright © 2004 by the Radiological Society of North America.
