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.