Presentation
Incidental findings in a patient with recurrent urinary tract infections.
Patient Data
Age: 55 years
Gender: Female
From the case:
Calcified hydatid cyst of spleen
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The CT scan demonstrates:
- diffuse hepatic steatosis
- mild hepatomegaly
- diffuse hypoattenuation of the liver
- liver-spleen differential attenuation on contrast-enhanced CT: liver (23 HU) - spleen (73 HU) = -50 HU). Hepatic steatosis from -20 to less than -43 HU
- calcified splenic mass: the peripheral calcification of the pericyst and internal serpentine calcification of the membranes (endocyst)
- Small right kidney with cortical thinning/scars and mild dilatation with distortion of the calyces (Chronic pyelonephritis)
Case Discussion
CT feature of a calcified splenic mass probably hydatid cyst with diffuse hepatic steatosis (incidental findings) in a patient with chronic pyelonephritis.
Splenic hydatid infection is considered as a rare form of hydatid disease, and isolated splenic involvement is even less common. usually asymptomatic.
The spleen is involved in three situations:
- systemic dissemination
- intraperitoneal spread from a ruptured hepatic hydatid cyst
- retrograde spread from the liver to the spleen via the hepatic portal and splenic veins in portal hypertension
The differential diagnosis for splenic hydatid cysts includes other splenic cystic lesions:
- splenic epidermoid cysts
- splenic pseudocysts
- splenic abscesses
- splenic hematomas
- cystic neoplasms of the spleen
- intrasplenic pancreatic pseudocyst
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