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GI: liver, biliary tree and pancreas > Benign Focal Lesions of the Liver > Flashcards

Benign Focal Lesions of the Liver Flashcards

1
Q

benign lesions include Haemangioma
Focal nodular hyperplasia
Adenoma
Liver cysts

with ____ being the most common benign tumour which is usually asymptomatic

A

Haemangioma

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2
Q

haemangioma is more common in males, true/false?

A

false

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3
Q

what is a haemangioma

A

a mass of atypical blood vessels

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4
Q

what investigations are done for haemangioma?

A

USS, CT (venous enhancement from periphery to center) , MRI

no need to biopsy

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5
Q

what is focal nodular hyperplasia?

A

it is a nodule formation of normal liver tissue caused by congenital problems in arterial flow which leads to a hyperplastic response.

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6
Q

what is focal nodular hyperplasia associated with?

A

osler-Weber-Rendu and liver haemangioma

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7
Q

histologically do FNH nodules show all types of cells in the liver (e.g. sinusoids, bile ductules and kupffer cells) or just hepatocytes?

A

all types of cells

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8
Q

does FNH have a relation with sex hormones?

A

no

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9
Q

which group is FNH more common in ?

A

young and middle aged women

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10
Q

how is FNH diagnosed?

A

US, CT, MRI, FNA

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11
Q

what would be seen on CT for FNH?

A

Classically (but not always) – central scar containing a large artery, radiating branches to the periphery

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12
Q

histologically do hepatic adenomas show all types of cells in the liver (e.g. sinusoids, bile ductules and kupffer cells) or just hepatocytes?

A

no - These are benign neoplasm composed of normal hepatocytes

no portal tract, central veins or bile ducts

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13
Q

adenomas are more common in females?

A

yes

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14
Q

do hepatic adenomas have a relation with sex hormones?

A

yes - contraceptive hormone associations

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15
Q

what may patients with hepatic adenoma present with?

A

assymptomatic

May present with rupture, hemorrhage, or malignant transformation (very rare)

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16
Q

how is hepatic adenoma diagnosed?

A

UC, CT, MRI, FNA - may be needed

17
Q

how is hepatic adenoma treated?

A

Stop hormones
and observe

Male patients more prone to develop malignant adenoma than female so it is now thought that the adenoma should be resected rather than monitored

18
Q

what are the 5 types of cystic lesions

A

Simple, Hydatid, Atypical, Polycystic lesion, Pyogenic or Amoebic abscess

19
Q

____ ___ - a Liquid collection lined by an epithelium with no biliary tree communication

A

simple cyst

20
Q

mostly simple cysts are ____ but symptoms can be due to ______, ______, ___ and ____

A

assymptomatic

haemorrhage, infection, rupture and compression

21
Q

___ ___ - This is a common complication of tapeworm parasite echinoccocus granulosus

A

hydatid cyst

22
Q

how is hydatid cyst diagnosed?

A

history and serologic testing - anti echinoccocus antibodies

23
Q

what are the management options for hydatid cyst ?

A

surgery

medical - albendazole

percutaneous drainage: PAIR

24
Q

what is polycystic liver disease?

A

Embryonic ductal plate malformation of the intrahepatic biliary tree

25
Q

what are the three types of PLD?

A

Von Meyenburg complexes (VMC)

Polycystic Liver disease

Autosomal dominant Polycystic Kidney disease

26
Q

what are the symptoms of PLD/

A

abdominal pain, abdominal distension, atypical symptoms due to voluminous cysts resulting in compression of adjacent tissue or failure of the affected organ

27
Q

VMC are Cystic bile duct malformations, originating from the ______ biliary tree

A

Cystic bile duct malformations, originating from the peripheral biliary tree

28
Q

are there predisposing genes to VMC?

A

no

29
Q

____ ____ ____ ____Liver function preserved and renal failure rare
Symptoms depend on size of cysts

A

Polycystic Liver disease

30
Q

are there predisposing genes to PCLD?

A

yes - PRKCSH and SEC63

31
Q

Renal failure due to polycystic kidneys and non-renal extrahepatic features are _____ in ADPKD

A

common

32
Q

are there predisposing genes to ADPKD?

A

yes– PKD1 and PKD2

33
Q

what are the features of ADPKD?

A

Hypertension
Abdominal aneurysms
Cardiac valve abnormalities

34
Q

what are the clinical features of liver abscess?

A

High fever
Leukocytosis
Abdominal Pain
Complex liver lesion

35
Q

what is important to find out in the history for liver abscess?

A

if they have had a recent abdo or biliary infection

dental procedure

36
Q

what is the management in liver abscess?

A

empirical antibiotics initially

aspiration/drainage percutaneously

ecg

GI: liver, biliary tree and pancreas (20 decks)

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