Hepatitis Does Not Cause Liver Cysts
Hepatitis does not cause liver cysts to develop. Liver cysts arise from congenital developmental abnormalities during embryonic development, not from inflammatory liver diseases like hepatitis.
Pathogenesis of Liver Cysts
Liver cysts form through a completely different mechanism than hepatitis-related liver damage:
- Hepatic cysts arise from abnormal embryonic ductal plate development, where the ductal plate fails to properly mature and instead disconnects from the biliary tree, progressing into fluid-filled cystic structures 1
- These are developmental disorders classified as ciliopathies due to shared cilia dysfunction in their pathogenesis, with a prevalence of simple hepatic cysts ranging from 2.5-18% in the general population 1
- The epithelial cells lining hepatic cysts retain secretory function, continuously producing fluid that generates positive luminal pressure contributing to cyst growth 1
Important Clinical Distinction
While hepatitis does not cause cysts, there is one documented scenario where hepatitis can affect pre-existing cysts:
- A rare case report documented rapid enlargement of a pre-existing hepatic hilar cyst that induced bile duct obstruction after acute exacerbation of chronic hepatitis B 2
- This represents a complication of an existing cyst during acute hepatitis, not hepatitis causing cyst formation 2
- In patients with acute hepatitis or acute exacerbation of chronic hepatitis who have pre-existing hepatic cysts, the cyst size should be monitored if located near critical structures 2
Types of Hepatic Cysts (None Caused by Hepatitis)
The recognized categories of liver cysts include:
- Simple congenital cysts - the most common type, arising from developmental abnormalities 3
- Polycystic liver disease - genetic disorder with multiple cysts 4
- Hydatid cysts - caused by parasitic infection (Echinococcus), not hepatitis 5
- Traumatic cysts - result from direct abdominal trauma 5
- Inflammatory cysts - rare, but not caused by viral hepatitis 5
Clinical Pitfall to Avoid
Do not confuse peribiliary cysts with hepatitis-caused lesions. Peribiliary cysts are often observed in patients with portal hypertension and cirrhosis (which can result from chronic hepatitis), but these cysts are characterized by their peculiar perihilar distribution and small size (<1 cm), and represent a separate entity from simple hepatic cysts 4. Even in this context, the cirrhosis creates the environment for peribiliary cyst detection, but hepatitis itself does not cause the cyst formation.