Giant and complicated variants of cystic bile duct hamartomas of the liver: MRI findings and pathological correlations

Diego R Martin, Bobby T Kalb, Juan M. Sarmiento, Thomas G. Heffron, Ipek Coban, N. Volkan Adsay

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: To describe a new category of liver cyst we propose calling "giant bile duct hamartoma (giant-BDH)" and to provide a more complete record of the magnetic resonance imaging (MRI) features of BDHs with potential for clinical impact. Materials and Methods: This study was Institutional Review Board (IRB)-approved and Health Insurance Portability and Accountability Act (HIPPA)-compliant. Fifteen patients were identified with surgical liver pathology in keeping with complicated BDH and MRI findings of giant cysts. Results: In all, 14/15 patients presented with pain that resolved in 14/14 with surgery. Imaging features common to pretreatment cysts included sharply defined, lobulated margins with thin, smooth rim-enhancement. Treated symptomatic cysts measured 9.8 cm on average and 21.6 cm maximum. The 14/15 patients had coexistent <2.0 cm BDH. Elevated T1 signal corresponded with hemorrhagic cyst content (10/15 patients); cyst-wall rimenhancement corresponded with histological findings of inflammation (15/15), fibrocystic changes (12/15), and smaller BDH in the adjacent liver (13/15). Histology of giant-BDH cyst walls corresponded with complicated BDH in 15/15. The incidence of symptomatic-treated BDH at our institution was 0.4%. Conclusion: BDH is a benign hepatic cystic lesion that may undergo cystic enlargement, internal hemorrhage, and clinically present with abdominal pain treatable by minimally invasive laparoscopic fenestration. Complicated giant-BDH coexists with smaller BDH and the MRI features of giant-BDH are characteristic.

Original languageEnglish (US)
Pages (from-to)903-911
Number of pages9
JournalJournal of Magnetic Resonance Imaging
Volume31
Issue number4
DOIs
StatePublished - 2010
Externally publishedYes

Fingerprint

Cystic Duct
Hamartoma
Bile Ducts
Cysts
Magnetic Resonance Imaging
Liver
Choledochal Cyst
Health Insurance Portability and Accountability Act
Surgical Pathology
Research Ethics Committees
Abdominal Pain
Histology
Hemorrhage
Inflammation
Pain
Incidence

Keywords

  • Bile duct hamartoma
  • Biliary hamartoma
  • Hepatic cyst
  • MRI
  • Von meyenburg complex

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Medicine(all)

Cite this

Giant and complicated variants of cystic bile duct hamartomas of the liver : MRI findings and pathological correlations. / Martin, Diego R; Kalb, Bobby T; Sarmiento, Juan M.; Heffron, Thomas G.; Coban, Ipek; Adsay, N. Volkan.

In: Journal of Magnetic Resonance Imaging, Vol. 31, No. 4, 2010, p. 903-911.

Research output: Contribution to journalArticle

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