Ciliated hepatic foregut cysts are a very rare type of hepatic cyst, with nonspecific radiological features. Less than a hundred of cases have been reported yet 1. They are usually benign, but rare cases of malignant degeneration (in squamous cell carcinoma) have also been reported 1-4.
They are more often seen in adults, although a few cases have been described in children (approximately ten cases) 5.
Histologically, they are similar to bronchogenic cyst.
They are composed of four layers including a ciliated pseudostratified columnar epithelium, a smooth muscle layer, a subepithelial connective tissue layer and an external fibrous capsule 5.
They are usually solitary, non-enhancing, unilocular, smaller than 3 cm and subcapsular in location 2. They often involve the segment IV of the liver.
They have a variable density, which ranges from hypodense (cystic) to isodense, to hyperdense (soft tissue density) on NECT 3.
Fluid-fluid levels are often seen, and the signal on MRI depends on its content (more fluid or proteinaceous).
- T1: variable signal from hypo-, iso-, to hyperintense, depending on the content of the cyst
- T2: predominantly hyperintense
- T1 C+: non-enhancing
Imaging differential considerations include:
- 1. Sharma S, Dean AG, Corn A et-al. Ciliated hepatic foregut cyst: an increasingly diagnosed condition. HBPD INT. 2009;7 (6): 581-9. Pubmed citation
- 2. Jakowski JD, Lucas JG, Seth S et-al. Ciliated hepatic foregut cyst: a rare but increasingly reported liver cyst. Ann Diagn Pathol. 2005;8 (6): 342-6. Pubmed citation
- 3. Kadoya M, Matsui O, Nakanuma Y et-al. Ciliated hepatic foregut cyst: radiologic features. Radiology. 1990;175 (2): 475-7. Pubmed citation
- 4. Wilson JM, Groeschl R, George B et-al. Ciliated hepatic cyst leading to squamous cell carcinoma of the liver - A case report and review of the literature. Int J Surg Case Rep. 2013;4 (11): 972-5. doi:10.1016/j.ijscr.2013.07.030 - Free text at pubmed - Pubmed citation
- 5. Khoddami M, Kazemi Aghdam M, Alvandimanesh A. Ciliated hepatic foregut cyst: two case reports in children and review of the literature. Case Rep Med. 2013;2013: 372017. doi:10.1155/2013/372017 - Pubmed citation
- 6. Fernández-Aceñero MJ, Corral JL, Manzarbeitia F. Ciliated hepatic foregut cyst: two further cases with an immunohistochemical analysis. Hepatogastroenterology. 2012;59 (116): 1260-2. Pubmed citation