Polycystic Liver Disease

As sonographic resolution capabilities improve and more abdominal sonograms are requested, diagnosis of polycystic liver disease (PLD) is on the increase. At first glance, the numerous liver cysts caused by PLD can be alarming. However, the disease is usually asymptomatic, and lab tests are generally within normal ranges. Prudent sonographers are advised to recognize and docu-ment the cysts for future reference in the event that symptoms progress. Appropriate reactions by the clinician, along with an understanding of the disease and its ramifications, are important to keep the patient informed. Key words: polycystic liver disease, asymptom-atic, liver cysts, sonography, autosomal domi-nant polycystic kidney disease Sonography students learn early in their careers that finding cysts in the liver is a signal to look for similar cysts in the kidneys and sometimes even the pancreas and/or the spleen. Sonographers often have a picture in their heads of Frank Netter’s polycystic kidney, which includes a drawing of both the kidney and liver severely deformed with similar cysts. Although cystic liver disease is com-monly associated with autosomal dominant polycystic kidney disease (ADPKD), polycystic liver disease (PLD) has been documented and stud-ied recently as a disease with its own identity and etiology.1 PLD is an inherited disorder, although in some cases, it appears to occur randomly, with no appar-ent cause.2 It is characterized by the presence of multiple, scattered, fluid-filled cysts of biliary ori-gin in the liver parenchyma. A few to many cysts ranging from a few millimeters to more than 15 centimeters in diameter are present.2 PLD can oc-cur in the absence of kidney cysts. This case study demonstrates such a situation—a patient diagnosed with PLD and no signs or symptoms of ADPKD