ABD 2 — Liver Flashcards
Which diagnosis is most likely to present sonographically as diminished vascular structures within the liver parenchyma?
Cirrhosis
A 50-year-old diabetic patient presents with abdominal pain and slightly elevated liver function tests. Hepatomegaly and diffuse increase in liver parenchymal echogenicity are present. What is this most characteristic of?
Fatty infiltration
What is the most common type of glycogen storage disease?
Von Gierke’s disease, Type 1
Which is associated with an immunocompromised patient?
Hepatic candidiasis
What is the most common cause of a hepatic hematoma in a child?
Blunt abdominal trauma
What is a mesenchymal hamartoma?
Rare, developmental, encapsulated, cystic tumor of the liver
What clinical finding is most associated with cavernous hemangioma of the liver?
Asymptomatic female
Patients who have hepatocellular carcinoma are likely to have had:
Cirrhosis
What is the most common form of malignant neoplastic involvement of the liver?
Metastases
Which liver pathology demonstrates a central stellate scar within a mass?
Focal nodular hyperplasia
What should be suspected if a patient presents with weight loss, increased alpha fetal protein (AFP), and abdominal enlargement?
Hepatoma
How do amebic parasites usually enter the liver?
Portal vein
Male patient has an increased AST and bilirubin. His liver demonstrated a “starry night” appearance and there was a gallbladder wall thickening. What could these findings represent?
Acute hepatitis
Which of the following is FALSE when it comes to hemangioendothelioma?
—multiple tortuous vessels within the lesion on color Doppler analysis
—infantile form of hepatic hemangioma
—more common in females (2:1)
—slow growing asymptomatic tumor
False: slow growing asymptomatic tumor
In what type of liver pathology is a collection of pus and/or debris and is most commonly from Escherichia coli.
Pyogenic abscess
What type of malignant liver tumor occurs in children 3 years old and younger and is associated with Beckwith-Wiedemann syndrome
Hepatoblastoma
What liver lesion consists of hepatocytes but no Kupffer cells and has a well documented associated with long-term oral contraceptive use.
Liver cell adenoma
Echinococcal cysts have the highest incidence in countries in which:
Sheep grazing is common
What is associated with the “wheel-within-wheel” pattern in the liver?
Candidiasis
True/False:
Hemangiosarcomas are rare malignancies that are seen in patients 35 - 55 years of age that have had prior exposure to Thorotrast, arsenic, or polyvinyl chloride.
False
(Hemangiosarcomas are seen in older patients; typically 60+)
(Correct risk factors would include genetic mutations and previous radiation therapy)
***Written
What are 2 of the 3 main sonographic traits would you use to help differentiate a benign mass from a malignant mass. You need to include whether or not you would see said characteristic in the benign or malignant mass. (not including color or pulse wave Doppler)
- Shape — A benign mass is more round/oval with smooth and well-defined borders. A malignant mass is shaped more irregular with poorly defined borders.
- Echogenicity — A benign mass has a homogeneous echogenicity while a malignant mass will appear more heterogeneous.
Both of these characteristics are seen sonographically within a bengin/malignant mass.
What benign liver lesion may demonstrate a color Doppler pattern similar to that of a malignant lesion?
FNH (focal nodular hyperplasia)
***Written
You are scanning Mr. Thompson. He is a 57 year old male there for an abdominal ultrasound for abdomen pain. He has a history of a cholecystectomy. While scanning the liver you notice an anechoic area at the porta hepatis. You put the color Doppler on and find the image below. What is most likely the diagnosis?
Describe what you are seeing in the image below.
My diagnosis would be a Hepatic artery Pseudoaneurysm. Seen is the Yin-Yang flow pattern within the pseudoaneurysm, indicating turbulent flow. The hepatic artery appears enlarged and is seen feeding into the pseudoaneurism. Also noted is some thrombus within the pseudoaneurism with no flow.
