Case contributed by Dr Sepehr Haghighi


Shortness of breath and abdominal pain

Patient Data

Age: 5 years
Gender: Male

Multiple hypodense masses are seen in both liver lobes without enhancement.

Two variable size hypodense masses are seen in spleen, one of which is near the splenic hilum showing water-lily appearance.

In lower lobes of both lungs, multiple hypodense lesions are evident.

Case Discussion

These masses are compatible with diffuse intrahepatic, splenic and lung hydatidosis. Hydatid disease is a parasitic zoonosis caused by the Echinococcus tapeworm.

CT features: Fluid density cyst, septa and daughter cysts may be visualized. The water-lily sign indicates a cyst with a floating, undulating membrane, caused by a detached endocyst. Fluid is of variable attenuation, depending on the amount of proteinaceous debris. May show dilated intrahepatic bile ducts due to compression or rupture of the cyst into bile ducts.

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