Presentation
Dyspnea. Incidental finding on abdominal slices of chest CT.
Patient Data
Subcapsular round heterogeneous calcification measuring 17 x 20 mm in hepatic segment 2.
Right basal pulmonary consolidation.
Case Discussion
This patient was referred from an area with a high prevalence of hydatid disease. Calcification is seen at radiography in 20–30% of hydatid cysts and usually manifests with a curvilinear or ring-like pattern, representing calcification of the pericyst.
Differential diagnosis for hepatic cystic lesions with calcification:
hydatid cyst (Echinococcus granulosa and Echinococcus multilocularis): calcification is common. Curvilinear, ring, peripheral calcification of main cyst or daughter cysts (granulosa), central ill-defined, irregular, coalescent (multilocularis) hydatid cyst is more likely given endemic disease.
epithelial cyst: peripheral curvilinear calcification in a nonenhancing cystic lesion
hemangioma: central coarse, large calcification in a hypodense lesion with centripetal filling
cystadenoma or cystadenocarcinoma: coarse mural and septal calcification
hemangioendothelioma: dystrophic calcification, capsular retraction