Ciliated hepatic foregut cyst. Report of a case with findings on fine needle aspiration

Ciliated hepatic foregut cyst (CHFC) is an uncommon cystic lesion of the liver. It is analogous in nature and pathogenesis to the bronchial cysts that occur in the mediastinum. We report a case of CHFC diagnosed on fine needle aspiration (FNA) with a discussion of the cytologic findings and features and a review of the literature. Abdominal computed tomography (CT) detected the lesion during a workup for metastatic squamous cell carcinoma of the cervix in a patient with an intrauterine contraceptive device and uterine Actinomyces infection. Subsequent CT-guided FNA produced clear, viscid material that revealed numerous macrophages and scattered ciliated columnar cells within the mucinous background. The cytology and radiologic findings were essentially similar to those of a bronchial cyst and did not conform to any of the findings in generally known lesions of the liver. Awareness of this rare hepatic lesion will result in an accurate and definitive diagnosis by guided FNA biopsy and avoidance of surgical exploration and excision biopsy.