Case 3

This is an ultrasound study of the abdomen showing a cystic lesion in the liver, which demonstrates detached, floating internal membranes – which is termed the ‘water lily’ sign. This sign is pathognomonic for a hydatid cyst / cystic echinococcosis in the transitional stage, representing the detached parasite membrane / endocyst within the larger cyst fluid. This corresponds to CE3A stage of the WHO classification.

There is another lesion in the liver, which is more heterogeneous and contains some solid components, yet also contains some smaller cysts within it. This corresponds to CE3B stage of the WHO classification.