Multiple biliary hamartomas are considered as rare benign malformations of the intrahepatic bile ducts.
Biliary hamartomas appear as scattered small well-circumscribed lesions in ultrasound in the liver, with hypoechoic, hyperechoic, or mixed echogenicity depending on the components.
On ultrasound, a "comet tail” sign may be seen, which is a nonspecific sign for biliary hamartomas. On CT, biliary hamartomas are hypodense multiple small size lesions with irregular margins. On MRI, they are hypointense on T1-weighted imaging and hyperintense on T2-weighted imaging and show no enhancement after gadolinium MRCP shows multiple cystic lesions non-communicating with the biliary tree 1.
Special thanks to Dr Tamer Elholiby.