Multiple biliary hamartomas - von Meyenburg complexes

Case contributed by Philippe Goldstein


Asymptomatic patient. Only the bilirubin was elevated. CT performed following findings on ultrasound.

Patient Data

Age: 50 years
Gender: Male

Multiple peripheral small liver cysts, some with internal septae, not connected with biliary tract. Otherwise liver is normal in size and signal.

Left kidney unusual cysts, with fluid-fluid level and one of them is complete hypointense on T2.

Case Discussion

Appearances are consistent with multiple biliary hamartomas (Von Meyenburg complexes). MRCP is important to differentiate from other biliary disorders (Caroli's disease) to prove or disprove communication with the biliary tree.

Multiple biliary hamartomas (Von Meyenburg complexes) do not communicate with the biliary tree on MRCP or ERCP. Hepatic cysts are usually solitary, may be multiple in ADPLD with usually multiple cysts kidneys and other organs. The hepatic cysts appear anechoic on ultrasonography. Caroli's disease shows multiple cysts communicating with the biliary tree with a "central dot" sign on CECT representing enhancing tiny dots (portal radicles) within dilated cystic intrahepatic ducts. 

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