011315 liver lesions Flashcards
benign primary liver lesions
hemangioma
focal nodular hyperplasia
adenoma
malignant primary liver lesions
hepatocellular carcinoma
cholangiocarcinoma
oral contraceptives can predispose to what kind of liver lesion?
hepatic adenoma
underlying liver disease can predispose to what?
hepatocellular carcinoma
history of primary sclerosing cholangitis can predispose to what?
cholangiocarcinoma
if there’s liver lesion in a noncirrhotic pt, what should you think of?
metastasis
should NOT think hepatocellular carcinoma
if there’s liver lesion in a cirrhotic pt, what should you think of?
primary liver lesion
most common benign liver lesion
hemangioma
hemangioma is found in noncirrhotic or cirrhotic liver?
noncirrhotic
what is a hemangioma?
congenital vascular malformations (blood filled cavities lined by endothelium)
malignant potential of hemangioma?
NONE
central stellate star
radiographic finding for focal nodular hyperplasia
what is focal nodular hyperplasia
rxn to intrahepatic anomalous artery leading to hyperperfusion (hyperperfused area enlarges until it outgrows its blood supply)
malignant potential of focal nodular hyperplasia?
none
hepatic adenoma
benign proliferation of hepatocytes
how is hepatic adenoma different from hemangiomas and focal nodular hyperplasia?
it has a risk of HEMORRHAGE and MALIGNANT TRANSFORMATION
tx for hepatic adenoma
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
prognosis for HCC
poor 5 year survival
most of HCC in the U.S. is caused by
Hep C and Hep B
how can you diagnose HCC?
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
alpha fetoprotein test
elevated in 60-70% of pts with HCC
however, should not be used by itself. should also look for liver lesion on imaging.
