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

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

Research output: Contribution to journalArticle

11 Scopus citations

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 - Apr 2010
Externally publishedYes

Keywords

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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