Which liver lesion may present with low-grade fever, leukocytosis, nausea, and normal LFT?

Which liver lesion may present with low-grade fever, leukocytosis, nausea, and normal LFT?

• A. Amoebic abscess
• B. Pyogenic abscess
• C. Echinococcal cyst
• D. Metastatic lesion

Answer: (C)

Think about a liver lesion that can stay functionally quiet while still causing mild systemic signs. Echinococcal (hydatid) cysts often present with normal liver function tests because the lesion sits inside the liver without acutely injuring hepatocytes. If fever and leukocytosis occur, they’re usually due to secondary infection of the cyst or rupture, which can also bring on nausea. In contrast, liver abscesses—whether amoebic or pyogenic—typically produce more pronounced fever and leukocytosis and often disrupt liver enzymes due to inflammation and biliary involvement. Metastatic lesions can be asymptomatic or cause symptoms from mass effect, but the specific combination of low-grade fever with leukocytosis and normal LFTs aligns best with an echinococcal cyst.

Think about a liver lesion that can stay functionally quiet while still causing mild systemic signs. Echinococcal (hydatid) cysts often present with normal liver function tests because the lesion sits inside the liver without acutely injuring hepatocytes. If fever and leukocytosis occur, they’re usually due to secondary infection of the cyst or rupture, which can also bring on nausea. In contrast, liver abscesses—whether amoebic or pyogenic—typically produce more pronounced fever and leukocytosis and often disrupt liver enzymes due to inflammation and biliary involvement. Metastatic lesions can be asymptomatic or cause symptoms from mass effect, but the specific combination of low-grade fever with leukocytosis and normal LFTs aligns best with an echinococcal cyst.