Ciliated hepatic foregut cyst

Last revised by Dr Jeremy Jones on 20 Sep 2021

Ciliated hepatic foregut cysts are a very rare type of hepatic cyst, with non-specific radiological features. They are usually benign, but rare cases of malignant degeneration (to squamous cell carcinoma) have also been reported. 

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 a 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:

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Cases and figures

  • Case 1
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