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Diaphragmatic Mesothelial Cyst: Radiological Appearance and Follow-Up Results During Childhood
Ismail Akdulum1, Mehmet Öztürk2, Sinan Karatoprak3
1Department of Pediatric Radiology, Gazi University, Ankara.
Insights
Pediatric diaphragmatic mesothelial cysts (DMC) show characteristic imaging findings on ultrasound. Most DMCs in children spontaneously resolve or decrease in volume, suggesting routine follow-up is often sufficient.
Area of Science:
- Radiology
- Pediatric Imaging
- Gastroenterology
Background:
- Diaphragmatic mesothelial cysts (DMC) are rare congenital anomalies.
- Accurate radiological diagnosis and follow-up are essential for appropriate management.
Purpose of the Study:
- To characterize the radiological findings of pediatric diaphragmatic mesothelial cysts.
- To evaluate the outcomes of diaphragmatic mesothelial cysts in children.
Main Methods:
- Retrospective analysis of 27 pediatric patients diagnosed with DMC between May 2014 and September 2018.
- Evaluation of imaging findings from ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI).
- Assessment of clinical indications, cyst localization, volume, and follow-up data.
Main Results:
- The most common indications for imaging were abdominal pain, diarrhea, and obesity.
- Mean DMC volume decreased from 2.62 mL at diagnosis to 2.45 mL during follow-up.
- Volume reduction occurred in 24 cases; 3 cases showed no change over a mean follow-up of 22.4 months.
- US revealed a characteristic bilobular cystic lesion with a fat indentation sign differentiating it from liver cysts.
Conclusions:
- The lateral fat sign on US is a key differentiator for pediatric diaphragmatic mesothelial cysts.
- Ultrasonography is highly effective for diagnosing and monitoring DMCs in children.
- Asymptomatic patients with stable cyst volumes may be managed with routine clinical and sonographic follow-up.
Abstract:
To identify radiological findings of diaphragmatic mesothelial cysts (DMC) in the pediatric age group and to assess follow-up outcomes.In this study, 27 pediatric age group patients were evaluated with ultrasonography (US), computed tomography (CT), or magnetic resonance imaging due to various clinical indications and diagnosed with DMC from May 2014 to September 2018. Age, sex, imaging indications and DMC localization, volumes in the first diagnosis, and follow-ups were retrospectively evaluated. Descriptive statistics were used for age, sex, imaging indications, and volume are presented as numbers and percentages.Ages range from 5 months to 13 years. Nine girls and 18 boys included in this study. The most common imaging indications were abdominal pain, diarrhea, and obesity. The mean volume of DMC was at first 2.62 and 2.45 mL during the follow-ups. There was volume reduction in 24 cases, and no change in 3 cases. Mean follow-up duration was 22.4 months. The US imaging findings were similar for all cases, bilobular cystic lesion with fat indentation between the cyst and liver parenchyma.The typical localization and lateral fat sign are useful in differential diagnosis of DMC from cystic lesions of liver. The US is a very effective and beneficial radiological method for diagnosis and follow-up. Routine clinical and sonographic follow-ups may be sufficient for asymptomatic patients with stable cyst volume.
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