6 - GU malignant radiology Flashcards

1
Q

% with aml who have tuberous sclerosis

A

10%

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2
Q

% with TS who have AML

A

80%

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3
Q

what is missing in simple cyst - 5

A

fluid attenuation, calcifications, septations, mural nodules, enhancement

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4
Q

bosniak 2f cyst % malig

A

11%

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5
Q

bosniac 1 cyst

A

water density, thin wall, no enhancement, no septation

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6
Q

bosniac 2 cyst

A

thin hairline septa with percieved enhancement (cant measure), 2. fine calcification or slightly thickened calcification in cyst wall

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7
Q

bosniak 2f cyst

A

no enhancement, multile thin hairline septa (percieved enhancement), thick/ nodular calcification on wall/septa, cyst > 3 cm w uniform high attenuation (>20hu)

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8
Q

bosniak 3 % malig

A

25-59%

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9
Q

bosniak 3

A

thickened/irregular septa or cyst with measureable enhancement

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10
Q

bosniak 4 % malig

A

80-100%

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11
Q

bosniak 4

A

same as bosniak 3 but with enhancing soft tissue components adjacent to but independent of septum/wall

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12
Q

ADPKD and cysts

A

bosniak 2-3 cysts are observes as there are many complex cysts

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13
Q

ADPKD RCC risk

A

not inc over gen pop

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14
Q

aquired PKD RCC risk

A

high risk of rcc

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15
Q

ADPKD vs aquired PKD extrarenal cyst location

A

ADPKD - liver 50%, pancreas 10%, intracranial berry aneurysm (deadly) 3-20%. Extrarenal rare in aquired

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16
Q

when does ADPKD present

A

3rd-5th decade

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17
Q

VHL more likely to get what mass?

A

RCC - lower malignant potential

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18
Q

when to tx mass in VHL

A

> 3 cm

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19
Q

difference between UCC and RCC

A

central lesion, rare calcification, extends into colelcting system

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20
Q

renal lymphoma characteristics

A

perinephric rind, or infiltrative mass, or renal hylar mass. Rarely onlu site of involvement

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21
Q

most common adrenal lesion

A

adrenal adenoma

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22
Q

most adrenal adenoma < x cm are benign

A

3

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23
Q

adrenal adenoma ct diagnostic findings - 3

A

nonenhanced CT < 10 HU. OR delayed contrast CT < 25 HU @ 15 min, OR contrast washout > 40-60% at 15 mins (noncontrast vs delayed)

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24
Q

3 MRI characteristics in adrenal adenoma dx - 3

A

(chemical shift MRI) adrenal:spleen < 0.7, OR opposed phase drops 20% (darkening of parenchyma on opposed phase imaging), or qualitative signal drop

25
Q

adrenal mets dx

A

appears hypodense compared to rest of adrenal

26
Q

most common adrenal mets from - (top 4)

A

lung, breast, lymphoma, melanoma

27
Q

adrenal lymphoma - more common type of lymphoma

A

NHL

28
Q

where in the adrenal gland are pheo’s found

A

medulla

29
Q

syndromes assd w pheochromocytoma

A

VHL, neurofibromatosis, tuberous sclerosis, MEN II and Iib

30
Q

pheo imaging characteristics - 3

A

intense enhancement, calcifications in 12%. (No fat or washout like adenoma). Can be cystic

31
Q

adrenal myelolipoma - 3

A

nonfunctional, benign, fatty on CT

32
Q

risk with adrenal myelolipoma

A

hemorrhage like AML

33
Q

adrenocortical carcinoma - sx

A

hyperfunctional in 50% (57% cushings)

34
Q

adrenocortical carcinoma - size

A

80% > 6 cm

35
Q

ACC - imaging- 3

A

heterogenious T1/Y2, hemorrhage/necrosis, nodular

36
Q

% of traumas with adrenal hemorrhage

A

2%

37
Q

adrenal hemangioma image characteristics -

A

**peripheral nodular enhancement**, central necrosis, 60% w calcifications

38
Q

adrenal hemangioma size

A

upto 15 cm

39
Q

what allows you to see prostate capsule well on MRI

A

high field strength

40
Q

what % UTUC will seed downstream

A

40%

41
Q

what kind of cyst is this

A

bosniac 1- water density, thin wall, no enhancement, no septation

42
Q

what kind of cyst is this

A

Bosniac 2 - thin hairline septa with percieved enhancement (cant measure), 2. fine calcification or slightly thickened calcification in cyst wall

43
Q
A

bosniac 2 - thin hairline septa with percieved enhancement (cant measure), 2. fine calcification or slightly thickened calcification in cyst wall

44
Q
A

bosniac 2 - thin hairline septa with percieved enhancement (cant measure), 2. fine calcification or slightly thickened calcification in cyst wall

45
Q
A

bosniac 2f - no enhancement, multile thin hairline cepts (percieved enhancement), thick/ nodular calcification on wall/septa, cyst > 3 cm w uniform high attenuatino (>20hu)

46
Q
A

bosniac 3 - thickened/irregular septa or cyst with measureable enhancement

47
Q
A

bosniac 3 - thickened/irregular septa or cyst with measureable enhancement

48
Q
A

bosniac 4 - same as bosniak 3 but with enhancing soft tissue components adjacent to but independent of septum/wall

49
Q
A

bosniac 4 - same as bosniak 3 but with enhancing soft tissue components adjacent to but independent of septum/wall

50
Q
A

PCKD

51
Q

embryoligic origin or adrenal cortex vs medulla

A

cortex - urogenital ridge, medulla - neural crest cells

52
Q
A
53
Q

cushings (not due to exogenous steroids) is usually due to a tumor located where? signifance of imaging

A

pituitary tumor therefore even unifocal enlargement reflects hyperplasia

54
Q

imaging and conns syndrome

A

even a tiny nodule can be an aldosteronoma and may require adrenalectomy.

55
Q

what is the lightbulb sign

A

high T2 signal intensity seen in pheo (practically not seen often)

56
Q

2 imaging findings suggestive of adrenal cortical carcinoma

A

venous invasion (only adrenal mass that does this), mets (35% present with mets)

57
Q

likelyhood af adrenal mass being initial manifestation of occult primary malignancy

A
58
Q

epidermoid cyst on us

A

well circumscribed, target like laminated appearance. +/- calcification in wall