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Hydatid cyst - calcified

Case contributed by Farid Rajaee Rizi
Diagnosis probable

Presentation

Dyspnea. Incidental finding on abdominal slices of chest CT.

Patient Data

Age: 80 years
Gender: Female
ct

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:

  1. 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.

  2. epithelial cyst: peripheral curvilinear calcification in a nonenhancing cystic lesion

  3. hemangioma: central coarse, large calcification in a hypodense lesion with centripetal filling

  4. cystadenoma or cystadenocarcinoma: coarse mural and septal calcification

  5. hemangioendothelioma: dystrophic calcification, capsular retraction

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