Liver Cysts

Question 1

Define liver cysts

Answer 1

Liver infection resulting in a walled-off collection of cyst fluid in the liver

Question 2

Aetiology of liver cysts

Answer 2

Simple: congenital
Polycystic liver disease
Neoplastic due to cystadenoma/adenocarcinomas
Hyadatid (echinoccal): infestation with parasite echonicococcus granulosus
Choledochal: congenital dilatation of the common bile duct
Caroli’s disease: cystic dilatation + polycystic kidney disease (autosomal recessive)

Question 3

Symptoms of liver cysts

Answer 3

Usually asymptomatic, may cause RUQ pain and bloating symptoms if large
Caroli’s - fever, abode pain, recurrent cholangitis
Hyadatid: may rupture through the diaphragm into the chest -> anaphylactic shock

Question 4

Signs of liver cysts on examination

Answer 4

If large - may be palpable
Jaundice due to obstruction
Hepatomegaly

Question 5

Investigations for liver cysts

Answer 5

Renal USS: multiple cysts seen
Cyst fluid drainage + aspiration: CA 19-9 may be seen (neoplastic)

FBC: eosinophilia (hyadatid)
LFTs: usually normal
Serum CA 19-9: may be raised (Neoplastic)
Echinococcal antibody titres: positive in echinococcal cysts

CT/MRI: multiple cysts