Brusic Ana, Oo June, Stella Damien L, Simkin Paul M, Loveday Benjamin Pt
Department of Radiology, Royal Melbourne Hospital, Parkville, Australia.
Surgical Oncology, Peter MacCallum Cancer Centre, Parkville, Australia.
Ultrasound. 2021 Aug;29(3):187-192. doi: 10.1177/1742271X20987263. Epub 2021 Jan 31.
Intracystic haemorrhage is a rare complication of hepatic cysts, and is often mistaken for a malignant lesion.
A 55-year-old female with a history of polycystic kidney and liver disease presented with a six-month history of abdominal distension, abdominal pain, early satiety, shortness of breath and 5 kg of weight loss. Imaging revealed a 20 cm mixed solid-cystic hepatic lesion containing peripheral avascular mobile echogenic material with a flame-like morphology. After experiencing symptomatic relief from ultrasound-guided aspiration, the patient underwent cyst fenestration for more definitive treatment.
Haemorrhagic hepatic cysts are uncommon and may present on imaging as having lace-like retractile clot, internal layering or shading of separating blood products or avascular mobile flame-like excrescences. The presence of avascular mobile flame-like excrescences appears to be a unique feature of haemorrhagic hepatic cysts.
While haemorrhagic hepatic cysts are rare and commonly mistaken for biliary cystadenomas or adenocarcinomas, the identification of particular features on high-resolution magnetic resonance imaging and contrast-enhanced ultrasound can lead to the correct diagnosis.
囊内出血是肝囊肿的一种罕见并发症，常被误诊为恶性病变。
一名55岁女性，有多囊肾和肝病病史，出现腹胀、腹痛、早饱、气短症状6个月，体重减轻5千克。影像学检查发现肝脏有一个20厘米的混合实性-囊性病变，周边有无血管的可移动回声物质，呈火焰状形态。在超声引导下穿刺抽吸后症状缓解，患者接受囊肿开窗术进行更确切的治疗。
出血性肝囊肿并不常见，在影像学上可能表现为有花边状可回缩血栓、血液成分分层或阴影，或无血管的可移动火焰状赘生物。无血管的可移动火焰状赘生物似乎是出血性肝囊肿的一个独特特征。
虽然出血性肝囊肿罕见，且常被误诊为胆管囊腺瘤或腺癌，但在高分辨率磁共振成像和对比增强超声上识别特定特征可导致正确诊断。
