Diaphragmatic mesothelial cyst

Case contributed by Dr Momen Mahmoud

Presentation

Recurrent abdominal pain.

Patient Data

Age: 35 years
Gender: Male
CT

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 coelomic remnants and are lined with mesothelial cells. Mesothelial cysts may be found in various anatomical places including the falciform ligament, adrenal gland, spleen, ovary, vaginal process of the testicle. 

CT scan demonstrates homogeneous, non-enhancing, well-defined water-density cyst. MRI shows 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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Case information

rID: 68911
Published: 25th Jun 2019
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included
Institution: Alazhar university hospitals

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