Presentation
Recurrent abdominal pain.
Patient Data
Thin wall water density cystic lesion with peripheral dots of calcification seen in the posterolateral aspect of the right costophrenic angle.
Case Discussion
Diaphragmatic mesothelial cysts are rare benign congenital lesions that originate from celomic remnants and are lined with mesothelial cells. Mesothelial cysts may be found in various anatomical places including the falciform ligament, adrenal gland, spleen, ovary, and vaginal process of the testis.
CT scan demonstrates a homogeneous, non-enhancing, well-defined water-density cyst. MRI shows a thin-walled cyst that is hypointense on T1-weighted images and hyperintense on T2-weighted images. Calcification of the cyst wall and internal echo might be seen. Extrahepatic location of the cyst can be confirmed by US, CT or MRI.
The diaphragmatic mesothelial cyst might be misdiagnosed as a posterior parahepatic cyst, simple liver cyst, hydatid liver cyst, intradiaphragmatic bronchogenic cyst, cystic teratoma, or subdiaphragmatic/subcapsular hepatic fluid collection such as pseudocyst, hematoma or abscess.
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