Diaphragmatic mesothelial cyst
Recurrent abdominal pain.
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Thin wall water density cystic lesion with peripheral dots of calcification seen in the posterolateral aspect of the right costophrenic angle.
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.
- 1. Kim MP, Hofstetter WL. Tumors of the diaphragm. (2009) Thoracic surgery clinics. 19 (4): 521-9. doi:10.1016/j.thorsurg.2009.08.007 - Pubmed
- 2. Esparza Estaún J, González Alfageme A, Sáenz Bañuelos J. Radiological appearance of diaphragmatic mesothelial cysts. (2003) Pediatric radiology. 33 (12): 855-8. doi:10.1007/s00247-003-1014-6 - Pubmed