Cystic lesions are commonly encountered on cross-sectional imaging and are usually an incidental finding without associated symptoms. They can be classified as either congenital or acquired. Cysts can occur in virtually any solid organ. When congenital, they are most common in the liver, pancreas, kidney, and ovary. Acquired cystic lesions such as lymphoceles, hematomas, seromas, urinomas, and bilomas can occur after surgery, trauma, or infection. Histologically, there are two broad categories: (a) true cysts, which are lined by epithelium, or (b) pseudocysts lined by fibrous or granulation tissue without epithelium. Symptoms may arise if they are large, complicated by hemorrhage or infection, or have undergone torsion. Excepting torsion (which should be treated surgically), single-session or multisession percutaneous aspiration and catheter drainage with or without sclerotherapy is a viable management strategy (1,2).

Percutaneous aspiration allows diagnostic analysis and can be therapeutic. When a cyst is large, catheter drainage is more efficient because a liter or more of fluid may be present (1). The catheter can be left in place for persistent drainage in the case of fluid reaccumulation. Cyst obliteration can occasionally be achieved via chronic drainage alone. If a cyst recurs after aspiration or drainage, sclerotherapy is a safe and effective option (3,4).

Sclerosants include povidone-iodine, tetracycline/doxycycline, bleomycin, cyanoacrylate, sodium tetradecyl sulfate, hypertonic saline, and acetic acid.
Although no consensus exists on sclerosant of choice, ethanol is readily available, inexpensive, and well-tolerated (2). More recently, sclerosis of lymphoceles has been performed with a fibrin-based tissue sealant (TISSEEL).