The liver is most commonly affected by this zoonosis. The cause is the Echinococcus granulosus or Echinococcus multilocularis tapeworm ....
• Variable appearance from a simple unilocular cyst to a complex heterogeneous cystic mass.
• Daughter cysts are a characteristic but rare finding—large central cyst with multiple small daughter cystic spaces peripherally.
• Detachment of the endocyst gives rise to ‘floating membranes’ within the cyst cavity.
• The ‘water lily sign’ is characteristic—a cyst with an undulating, floating membrane with a detached endocyst.
• 20%-30% of cysts calcify—usually curvilinear or ring-like.
• There is a risk of anaphylaxis with cyst aspiration due to intravascular transfer of cyst contents.
• Wall and septae enhance with contrast (unlike a simple liver cyst).
• Predilection for the lower lobes of the lungs, with disease more common on the right (multiple in 20%, bilateral in 20%).
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