Presentation
Flank pain.
Patient Data
Small, round (~5 mm) nodule along the posterior right hepatic lobe at the level of the upper pole of the right kidney, closely approximating the posterior right hemidiaphragm.
There is also a non-inflamed duodenal diverticulum and prostatomegaly.
Arrows indicated the location of the small posterior parahepatic cyst.
Case Discussion
I have noticed this incidental finding time and again, and wasn't sure what to make of it. It took some digging and contacting several abdominal imagers, but finally someone shared the article on posterior parahepatic cysts with me!
Posterior parahepatic cysts are a benign, incidental finding of a small cyst (or cysts) characteristically occurring posterior to the right hepatic lobe. They are not expected to grow or enhance. The major differential is diaphragmatic infolding (which is obvious on coronal/sagittal reformats) or retroperitoneal metastases (unlikely to be an isolated finding without mets elsewhere). Keep your eyes peeled, I'm sure you'll come across one soon!
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