Well-defined solitary cyst. A well-rounded, echo-free mass with acoustic enhancement, usually less than 3 cm in diameter, and often a chance finding without symptoms, is likely to be a solitary simple congenital cyst. A small hydatid cyst must also be excluded and cannot always be differentiated sonographically.
Solitary cyst with a rough irregular outline.
Multiple cystic lesions. Multiple spherical cystic masses of varying sizes, completely echo-free with a sharp outline and posterior acoustic enhancement, may indicate congenital polycystic disease. Search for cysts in the kidney, pancreas, and spleen; the congenital cystic disease can be very difficult to differential from hydatid disease.
Complex cyst. Hemorrhage or infection of any cyst may result in internal echoes and resemble an abscess or necrotic tumor.
Echinococcal cyst. Hydatid disease can present a broad spectrum of sonographic features.
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