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Gut. 2007 October; 56(10): 1352.
PMCID: PMC2000287



From question on page 1336

Multiple high signal cystic lesions in both lobes of the liver, which did not enhance with gadolinium or connect with the intra‐hepatic biliary tree, could be seen on the T2‐weighted MRI scan. The lesions had low attenuation on the CT scan and low signal on the T1‐weighted MR scan. These findings are most consistent with biliary hamartomas.

Bile‐duct hamartomas form during embryological development from insufficient resorption of the ductal plate, necessary for bile‐duct formation. Also known as von Meyenburg complex, they are characteristically multiple, uniform in size and surrounded by variable amounts of fibrous stroma.

Biliary hamartomas have an estimated incidence of 1%–3%, are commonly asymptomatic, discovered incidentally, and require no treatment. Successful transplantation of an affected donor liver has been reported. Vague abdominal pain and malignancies have been documented. Differential diagnoses include metastases and micro‐abscesses. MRI excludes these by demonstrating homogenous cyst size and signal intensity, with sharply demarcated lesions.

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