Cross-sectional imaging and laparoscopic findings of diaphragmatic mesothelial cysts
To present cross-sectional imaging, surgical findings, and follow-up results of diaphragmatic mesothelial cysts. Radiological findings for location, size, shape, and internal structure of cysts were reviewed retrospectively. For patients that underwent surgery, surgical reports and laparoscopy image...
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| Published in: | Clinical radiology Vol. 75; no. 3; pp. 239.e9 - 239.e14 |
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| Main Authors: | , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
England
Elsevier Ltd
01-03-2020
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| Online Access: | Get full text |
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| Summary: | To present cross-sectional imaging, surgical findings, and follow-up results of diaphragmatic mesothelial cysts.
Radiological findings for location, size, shape, and internal structure of cysts were reviewed retrospectively. For patients that underwent surgery, surgical reports and laparoscopy images were reviewed. In conservatively managed patients, changes in size and imaging findings of the cyst were assessed during follow-up visits.
A total of 13 paediatric cases with an imaging and/or pathological diagnosis of diaphragmatic mesothelial cyst were identified. In all cases, the cystic lesions were located between the diaphragm and the posterolateral aspect of the right lobe of the liver. Eleven lesions (84.6%) had a bi-lobulate shape. Eight of these cases underwent laparoscopic cyst aspiration/unroofing. The postoperative course was uneventful and there were no cases of recurrence. The remaining five cases were managed conservatively with follow-up available in four cases. In three cases (75%), there was reduction in the size of the cysts with a mean volume reduction of 55%.
Diaphragmatic mesothelial cysts are congenital cystic lesions that are usually detected incidentally. A common pitfall is incorrect interpretation of the lesion as a hepatic cyst. Conservative management with imaging follow-up can be adopted in asymptomatic cases with typical imaging findings.
•Primary tumors of the diaphragm are rare and simple cysts constitute the majority of benign lesions.•Diaphragmatic cysts can be grouped as mesothelial or bronchogenic based on the lining cell type.•Diaphragmatic mesothelial cysts are congenital cystic lesions, detected as incidental findings on ultrasound or cross-sectional imaging.•Close anatomical relationship with adjacent liver and lung can pose diagnostic challenges.•Radiologic features for diagnosis include extracapsular location in the right posterior segment of the liver and bilobulated shape. |
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| Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
| ISSN: | 0009-9260 1365-229X |
| DOI: | 10.1016/j.crad.2019.10.020 |