KEY FACTS
Terminology
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Cystic dilatation of obstructed periductal glands of bile ducts
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Retention cyst of peribiliary gland
Imaging
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Well-defined, cystic structures adjacent to portal triads
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Usually multiple; discrete, round/oval/tubular, or confluent configuration
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Variable size, from 2 mm to 2 cm
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Smooth and thin walls without internal echoes
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No enhancement of contents on CECT or MR
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Nonopacification with direct cholangiography or hepatobiliary-phase MR using hepatocyte-specific contrast agent
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Do not communicate with biliary tree
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Top Differential Diagnoses
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Biliary ductal dilatation
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Caroli disease
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Hepatic autosomal dominant polycystic disease
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Periportal edema/inflammation
Pathology
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Disturbed portal venous flow, periductal fibrosis, and inflammation → obliteration of neck of peribiliary glands → formation of retention cyst
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Associated with chronic hepatitis, cirrhosis, portal hypertension, portal vein thrombosis, liver transplantation
Clinical Issues
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Peribiliary cysts are typically asymptomatic; symptoms often related to underlying liver disease
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Obstructive jaundice may occur in end-stage liver cirrhosis or as complication of postliver transplantation
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May increase in size and number of cysts as cirrhosis progresses
Scanning Tips
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Do not confuse peribiliary cysts for biliary ductal dilatation