Diagnostic Ultrasound - Abdomen and Pelvis

Biliary Cystadenoma/Carcinoma
(Left) Transverse grayscale
ultrasound of the liver shows a
biliary cystadenoma with
complex cystic appearance.
Multiple thick septations ſt
are seen throughout the mass.
Posterior acoustic
enhancement of the lesion
confirms the cystic nature of
the lesion. (Right) Axial CT in
the same patient shows the
biliary cystadenoma with
lobulated contour, multiple
septations, and tiny focus of
calcification along the
periphery ſt. Note how
septations are seen to better
advantage on corresponding
ultrasound.
Diagnoses: Liver
(Left) Longitudinal grayscale
ultrasound shows a large
unilocular biliary cystadenoma
in the liver with several
thickened septations ſt.
(Right) Axial T2-weighted MR
with fat saturation of the liver
in the same patient shows
unilocular biliary cystadenoma
with multiple internal
septations . Biliary
cystadenomas are typically T2
hyperintense due to water
content. However, variable
hemorrhage or protein
content may result in
decreased T2 signal intensity
(not seen in this case).
(Left) Coronal CECT shows a
biliary cystadenocarcinoma
with rounded peripheral
enhancing mural nodules st
and thick septation ſt.
Associated biliary ductal
dilatation is seen . The
degree of complexity with
enhancing mural nodules
makes this lesion more
suspicious for biliary
cystadenocarcinoma. (Right)
Histology of a biliary
cystadenoma in a different
patient displays bland
cuboidal to columnar
epithelium associated with
spindle cell stroma resembling
ovarian-type stroma .
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