Multiple Microhamartomas of the Biliary Tract System (Von Meyenburg Complexes) with Multiple Liver Cysts — Diagnostic Imaging and Laparoscopic Findings —

: We present two patients with multiple microhamartomas of the biliary tract (von Meyenburg complexes) with multiple liver cysts with special reference to their diagnostic imaging and laparoscopic findings. Case 1 was a 76-year-old male and case 2 was 51-year-old male, who was later found to have adenocarcinoma of the common bile duct as a complication. The characteristic findings of ultrasonography (US) were markedly heterogeneous and there was a severe hyperechoic pattern in the liver with small cystic lesions. Computed tomography (CT) demonstrated multiple low attenuation focal defects scattered throughout both lobes which showed no enhancement following the application of intravenous contrast medium. Laparoscopically, multiple whitish nodular or stellate-shaped lesions, which were slightly depressed, and multiple small dark greenish cystic lesions of various sizes were scattered on the smooth surface of both lobes. Some dark greenish cystic lesions and whitish lesions were adjoining. A histological study of the whitish nodular lesions revealed a collection of proliferated and irregularly dilated bile ducts and ductules in a dense fibrous stroma. These findings are compatible with microhamartomas. These features are characteristic of this disease, and support the close association between liver cysts and microhamartomas. Our hypothesis is that a polycystic liver may result from cystic dilatation of microhamartomas.