011315 liver lesions

Question 1

benign primary liver lesions

Answer 1

hemangioma
focal nodular hyperplasia
adenoma

Question 2

malignant primary liver lesions

Answer 2

hepatocellular carcinoma

cholangiocarcinoma

Question 3

oral contraceptives can predispose to what kind of liver lesion?

Answer 3

hepatic adenoma

Question 4

underlying liver disease can predispose to what?

Answer 4

hepatocellular carcinoma

Question 5

history of primary sclerosing cholangitis can predispose to what?

Answer 5

cholangiocarcinoma

Question 6

if there’s liver lesion in a noncirrhotic pt, what should you think of?

Answer 6

metastasis

should NOT think hepatocellular carcinoma

Question 7

if there’s liver lesion in a cirrhotic pt, what should you think of?

Answer 7

primary liver lesion

Question 8

most common benign liver lesion

Answer 8

hemangioma

Question 9

hemangioma is found in noncirrhotic or cirrhotic liver?

Answer 9

noncirrhotic

Question 10

what is a hemangioma?

Answer 10

congenital vascular malformations (blood filled cavities lined by endothelium)

Question 11

malignant potential of hemangioma?

Answer 11

NONE

Question 12

central stellate star

Answer 12

radiographic finding for focal nodular hyperplasia

Question 13

what is focal nodular hyperplasia

Answer 13

rxn to intrahepatic anomalous artery leading to hyperperfusion (hyperperfused area enlarges until it outgrows its blood supply)

Question 14

malignant potential of focal nodular hyperplasia?

Answer 14

none

Question 15

hepatic adenoma

Answer 15

benign proliferation of hepatocytes

Question 16

how is hepatic adenoma different from hemangiomas and focal nodular hyperplasia?

Answer 16

it has a risk of HEMORRHAGE and MALIGNANT TRANSFORMATION

Question 17

tx for hepatic adenoma

Answer 17

discontinue contraceptives (to see if it shrinks)
avoid pregnancy (b/c preg can increase risk of growth and bleeding)
surgical resection to avoid risk of cancer and tumor rupture

Question 18

prognosis for HCC

Answer 18

poor 5 year survival

Question 19

most of HCC in the U.S. is caused by

Answer 19

Hep C and Hep B

Question 20

how can you diagnose HCC?

Answer 20

can diagnose just with imaging studies to look at hypervascularity in the arterial bed to the liver that washes out during the venous phase

don’t even need biopsy

Question 21

alpha fetoprotein test

Answer 21

elevated in 60-70% of pts with HCC

however, should not be used by itself. should also look for liver lesion on imaging.