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 Diagnosis
 Fatty Degeneration of Hydatid cyst

 Radiological Findings, Disease course, and Management

 

 Ultrasound Liver

  

 

 

 

 

 

 

 

 

   

 

 

 Findings

  • A well defined anechoic cystic lesion with imperceptible wall and focal wall irregularities along the medial wall in the right lobe of the liver

  • No internal echoes/calcifications

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 CT

 

 

 

 

 

 

 

 

 

 

 

 Findings

  • well defined hypodense cystic lesion  in the right lobe of liver with imperceptible walls and thin enhancing internal septations.

  • Few scattered fat densities within the cyst

 

 MRI

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Findings

  • well defined hypointense cyst wall 

  • Better defined daughter cyst

  • Presence of fat confirmed

 

Impression

 Fatty degeneration of hydatid cyst

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Discussion

   Background

  • Fat within a Hepatic Hydatid Cyst has only rarely been described in the literature

  • Fat within a Hydatid Cyst is seen as fat-fluid levels or as globules of fat

  • It is related to degeneration of hydatid membranes

  • Increasing cholesterol in cyst fluid has been associated with maturation and degeneration, therefore, development of fatty attenuation seems to be related to the ageing process of the cyst

  • Fat-fluid levels within a HHC detected on imaging studies favour the presence of a biliary communication and, in most patients, such a communication can be demonstrated on imaging. However, small globules of lipid / fat within a HHC can be explained by degeneration of the hydatid membranes as part of the ageing process of the HHC

 

 Conclusion

  • Fat within HHCs is a rare finding 

  • can be attributed to communication of the cyst with the biliary tree or to the process of degeneration of the hydatid membranes due to ageing of the cyst

  • fat within HHCs, although rare, can occur 

  • presence of a fat-fluid level within a HHC should lead to a search for a biliocystic communication, whereas the presence of small globules of fat needs not indicate a communication with the biliary tree and can be explained by degeneration of hydatid membranes as a part of ageing of the hydatid cyst.

References

Case 9

                                       Contributors

                                                Dr. Ambika Sunil Gayad                                                   

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