Presentation
Left upper quadrant pain in a patient of rural origin.
Patient Data
Age: 25 years
Gender: Male
From the case:
Splenic hydatid cysts
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The MRI sequences demonstrate two splenic cystic lesions:
- the upper pole cystic lesion measures 42x 30 x 27 mm of low signal on T1, high signal on T2 with no peripheral enhancement, containing detached, irregular laminated membranes of high signal on T1, low signal on T2, floating within the content "water lily sign".
- the lower pole unilocular cyst measures 55 x 50 x 45 mm of low signal on T1, high signal on T2 with no enhancement. The pericyst shows a high signal on T1 and a low signal on T2.
The rest of the abdominal organs are unremarkable.
Case Discussion
MRI features most consistent with two splenic hydatid cysts in a patient of rural origin. In this case, the chest x-ray (not shown) was normal.
Splenic hydatid infection is considered a rare form of hydatid disease, and isolated splenic involvement is even less common.
The spleen is involved in three situations:
- systemic dissemination
- intraperitoneal spread from a ruptured hepatic hydatid cyst
- retrograde spreads from the liver to the spleen via the hepatic portal and splenic veins in portal hypertension