Hydatid cyst of liver (gross pathology)
Adult male who presented with abdominal pain, nausea and vomitting. On examination, there was right upper quadrant tenderness and hepatomegaly.
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Abdominal CT scan (not shown) showed a single large cyst in the right lobe of liver measuring 12 cm. It appeared to contain several smaller cysts within it. The findings were considered to be diagnostic of hydatid cyst. The patient also had mild peripheral eosinophilia.
The image shows parts of the collapsed wall of the larger cyst (lower right and upper left) and several intact daughter cysts ranging in size from 1 cm to 5 cm.
Hydatid disease is a zoonotic parasitic infestation caused by the tapeworms belonging to the genus Echinococcus. The most common species is Echinococcus granulosus which causes the cystic form of the disease. Echinococcus multilocularis is less commonly seen but causes a more virulent form of the disease.
This patient received preoperative albendazole followed by surgical resection of the cyst. Liver biopsy is contraindicated for diagnostic purposes since the accidental entry of cyst fluid into the circulation can cause anaphylactic shock.