Biliary hamartomas were an incidental finding in a 33-year-old man who was investigated for recurrent episodes of biliary colic. A T2-weighted coronal image showed multiple small hyperintense lesions of similar size scattered in both lobes of the liver (Figure). Biliary microhamartomas (von Meyenburg complexes) are rare and usually multiple. They occur because of ductal plate malformation and are composed of dilated intralobular and interlobular bile ducts.1 They generally remain asymptomatic and do not affect liver functions, and are most commonly detected incidentally.2 Differential diagnosis of this rare clinical entity includes multiple simple liver cysts, Caroli disease and, less commonly, metastatic liver disease (with necrosis).
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.