Diagnosis
As described in the vignette, on ultrasound exam, LMs present as multi-loculated cystic masses. Fluid levels may be present if the cystic spaces contain blood, pus or chyle (60,61). LMs can be classified as either microcystic (less than 1 cm in size), macrocystic (greater than 1 cm in size) or mixed (62). The US image for this patient is seen in Fig 5A and 5B, and was consistent with a macrocystic LM. Similar to ultrasound, on MRI, LMs present as cystic masses. No solid enhancing component should be seen, unless a LM is microcystic in which case it can appear as a solid mass (61). Table 2 summarizes key imaging features of both LM and VM by imaging modality including US, CT and MRI.