Benign Neoplastic Diseases Flashcards
1
Q
What type of estrogen exposure affects a hemangioma?
A
HRT or pregnancy (BCP dose too low)
2
Q
size of a liver hemangioma
A
typically up to 3 cm
3
Q
gender prevalence of a hemangioma
A
females>males
4
Q
appearance of liver hemangioma
A
small, homogeneous, hyperechoic, well-defined
may exhibit necrotic or degenerative central area
5
Q
vascularity of hemangioma
A
often too slow to pick up
6
Q
Characteristics of benign neoplasms
A
asymptomatic and do not often alter lab tests
hypo/avascular
well-defined and encapsulated
slow growing
7
Q
Identify: small, benign, homogeneous, hyperechoic, well-defined liver mass, may have central hypoechoic/anechoic area, vascularity too slow to pick up
A
liver hemangioma, lipoma
8
Q
What tests could be performed to confirm diagnosis of a hemangioma?
A
MRI, CT, red blood cell scintigraphy - hot due to capillary bed
9
Q
What follow up is suggested for a liver hemangioma?
A
serial ultrasounds
10
Q
Common echogenicity of benign liver neoplasms
A
hyperechoic
11
Q
What is focal nodular hyperplasia?
A
proliferation of growth of normal liver cells in an abnormal arrangement (non-hexagonal)
12
Q
What is the functional unit of the liver?
A
lobule
13
Q
What are the components of a liver lobule?
A
hepatocytes, canaliculi, venous sinuses, Kupffer/reticuloendothelial cells
14
Q
gender prevalence of FNH
A
women>men
15
Q
size of FNH
A
up to 8 cm
16
Q
vascularity of FNH
A
some central flow
17
Q
appearance of FNH
A
small-med size, homogeneous, isoechoic, well-defined liver mass, hypoechoic central scar
18
Q
What test(s) could be performed to confirm diagnosis of FNH?
A
sulphur colloid scan - FNH is warm or hot because of increased density of Kupffer cells
19
Q
What is the most common benign liver neoplasm?
A
hemangioma
20
Q
liver “stealth lesion,” aka
A
FNH
21
Q
What follow up is suggested for a FNH?
A
serial ultrasounds
22
Q
Identify: small-med size, benign, homogeneous, isoechoic, well-defined liver mass, central vascularity, hypoechoic central area, influenced by estrogen
A
FNH
23
Q
benign liver neoplasm that is affected by estrogen
A
hemangioma and FNH
24
Q
What two benign liver neoplasms can a sulphur colloid scan differentiate?
A
FNH - warm or hot
liver adenoma - cold
25
size of liver adenoma
8-15 cm
26
appearance of liver adenoma
variable echogenicity (usually hyper), well defined and encapsulated, solitary mass
27
vascularity of liver adenoma
central flow
28
What follow up is suggested for a liver adenoma?
surgical removal due to risk of hemorrhage and infarct
29
Which benign liver neoplasm is linked to use of oral contraceptives and Type 1 Glycogen Storage Disease?
liver adenoma
30
Type 1 Glycogen Storage Disease, aka
von Gierke's disease
31
What test can be performed to confirm diagnosis of liver adenoma?
sulphur colloid scan would be cold - lack Kupffer cells
32
Identify: large, variable echogenicity (usually hyper), well defined and encapsulated, solitary mass, central vascularity
liver adenoma
33
appearance of lipoma
homogeneous, hyperechoic, well-defined liver mass, may have central hypoechoic/anechoic area
34
liver hemangioma, aka
cavernous hemangioma
35
most common benign splenic neoplasm
hemangioma
36
size of splenic hemangioma
variable: S -> L
37
appearance of splenic hemangioma
variable - hyperechoic, homogeneous and solid, or complex with cystic degeneration
38
What is a hemangioma?
cluster of blood capillaries
38
vascularity of splenic hemangioma
absent or low, flow too slow
40
name two rare benign splenic neoplasms
hamartoma, lymphangioma
41
suggested follow up for splenic hemangioma
further testing to rule out malignancy
42
appearance of a hamartoma
echogenic, solid, homogeneous, NON-ENCAPSULATED
43
What do a hamartoma and lymphangioma have in common?
lymphoid origin from spleen
44
appearance of lymphangioma
variable, solid or cystic
45
What is cystic lymphangiomyomatosis?
multiloculated cystic lymphangioma
46
multiloculated cystic version of lymphangioma
lymphangiomyomatosis
47
normal GB wall thickness
3 mm
48
appearance of GB adenoma
small-mid size, hyperechoic, homogeneous, pedunculated
49
size of benign GB adenoma
up to 10 mm
50
vascularity of GB adenoma
avascular or hypovascular
51
Identify: small-mid size, hyperechoic, homogeneous, pedunculated GB mass, hypo/avascular
GB adenoma, cholesterolosis, or cholesterol polyp
52
cholesterolosis
multiple non-shadowing masses attached to GB wall
53
multiple non-shadowing masses attached to GB wall
cholesterolosis
54
What is adenomyomatosis?
cholesterol trapped within exaggerated RA sinuses, and proliferation of the smooth muscle within the GB wall
55
appearance of adenomyomatosis
hyperechoic foci in a thickened GB wall, exhibiting comet-tail artifact
56
appearance of adenomyoma
focal, mass-like accumulation of adenomyomatosis
57
most common location of adenomyomatosis
GB fundus
58
appearance lent to GB by of mid-level adenomyomatosis
hourglass shape
59
exocrine pancreatic cells
acini cells - produce digestive enzymes that drain into duodenum through pancreatic duct
60
endocrine pancreatic cells
Islets of Langerhans - secrete insulin and other hormones
61
most common pancreatic neoplasm
Islet cell tumour
62
most common type of Islet cell tumour
Insulinoma
63
typical location of insulinoma
pancreatic body or tail
64
non-functioning Islet cell tumour
less common (15%), more commonly malignant
65
functioning Islet cell tumour
more common (85%), usually benign
66
appearance of Islet cell tumour
variable size, hypoechoic, solid, well-encapsulated,
67
AML
angiomyolipoma
68
angiomyolipoma, aka
renal hamartoma
69
renal hamartoma, aka
angiomyolipoma
70
gender prevalence of AML
middle-aged women
71
appearance of AML
unilateral, hyperechoic, homogeneous, well defined, in peripheral renal cortex (may be exophytic)
72
vascularity of an AML
hypo/avascular, flow too low
73
Identify: unilateral, hyperechoic, homogeneous, well defined, hypo/avascular mass in peripheral renal cortex
AML/renal hamartoma or renal cell carcinoma
74
Which benign neoplasm is associated with tuberous sclerosis?
AML/renal hamartoma
75
size of renal adenoma
up to 3 cm
76
size of oncocytoma
greater than 3 cm
77
gender prevalence of renal adenoma/oncocytoma
male>females
78
age prevalence of renal adenoma/oncocytoma
60's-70's
79
appearance of renal adenoma/oncocytoma
hypoechoic (sometimes isoechoic), well-defined mass in renal cortex
80
Identify: hypoechoic (sometimes isoechoic), well-defined mass in renal cortex
renal adenoma/oncocytoma, renal cell carcinoma, or dromedary hump (if pyramids seen)
81
appearance of adrenal adenoma
solid, round, unilateral, hypoechoic, encapsulated, may contain calcs
82
normal echogenicity of adrenals
thin echogenic medulla, hypoechoic cortex
83
zones of adrenal cortex
zona glomerulus, zona fasciculata, zona reticularis
84
hormones secreted by adrenal cortex
steroids (aldosterone, cortisone, estrogens, androgens
85
diseases associated with a hyperfunctioning adrenal adenoma
Cushing's syndrome, Conn's disease
86
hyperfunctioning adrenal adenoma vs non-functioning
both may be benign, but non-functioning is more common
87
name two non-functioning benign adrenal neoplasms
adrenal adenoma and myelolipoma
88
name two hyperfunctioning benign adrenal neoplasms
adrenal adenoma and pheochromocytoma
89
name two cortical benign adrenal neoplasms
adrenal adenoma and myelolipoma
90
medullary benign adrenal neoplasm
pheochromocytoma
91
origin of pheochromocytoma
adrenal medulla
92
origin of myelolipoma
zona fasciculata of adrenal cortex
93
origin of adrenal adenoma
adrenal cortex
94
gender prevalence of myelolipoma
males = females
95
appearance of myelolipoma
small-mid size, hyperechoic
96
Which benign adrenal neoplasm causes propagation speed artifact?
myelolipoma (fatty component)
97
size of myelolipoma
up to 5 cm
98
symptoms of pheochromocytoma
elevated catecholamines in urine, HTN, palpitations, tachycardia, excessive sweating
99
age prevalence of pheochromocytoma
40's-50's
100
age prevalence of myelolipoma
50's-60's
101
Which adrenal gland is more commonly afflicted with a pheochromocytoma?
right side
102
size of pheochromocytoma
greater than 2 cm
103
appearance of pheochromocytoma
solid, unilateral, encapsulated, hypoechoic, may be either homo or heterogeneous
104
Which benign adrenal neoplasm is associated with tuberous sclerosis and MEN syndrome?
pheochromocytoma
105
MEN syndrome
multiple endocrine neoplasia syndrome
106
tuberous sclerosis
genetic condition exhibiting mental retardation, seizures, sebaceous tumours
107
syndrome associated with "fits and zits"
tuberous sclerosis
108
Identify: small-mid size, solid, unilateral, hypoechoic, encapsulated adrenal medullary mass, may be either homo or heterogeneous; causes elevated catecholamines in urine, HTN, palpitations, tachycardia, excessive sweating
pheochromocytoma
109
Identify: small-mid size, hyperechoic adrenal cortical mass, causing propagation speed artifact
myelolipoma
110
most common benign abdominal wall neoplasm
desmoid tumour
111
desmoid tumour location
connective tissue, usually anterior abdominal wall, at a previous surgical or laparoscopic site
112
Which surgery is commonly associated with developing a Desmoid tumour?
C-section
113
gender prevalence of Desmoid tumour
females>males
114
age prevalence of Desmoid tumour
20's-30's (reproductive age)
115
appearance of Desmoid tumour
homogeneous and hypoechoic, local infiltration
116
Identify: homogeneous and hypoechoic mass in anterior abdominal wall, local infiltration, at site of previous surgery
Desmoid tumour
117
appearance of lipoma
mild to highly hyperechoic
118
features of a benign lipoma
mobile, compressible
119
Identify: hyperechoic lesion in the abdominal wall, mobile, compressible
lipoma
120
appearance of microcystic pancreatic neoplasm
well-defined, multiple small cysts - may appear solid and hyperechoic due to multiple cystic interfaces
121
size of microcystic pancreatic neoplasm
less than 2 cm
122
most common location for microcystic pancreatic neoplasm
pancreatic head
123
microcystic pancreatic neoplasm, aka
pancreatic serous cystadenoma
124
pancreatic serous cystadenoma, aka
microcystic pancreatic neoplasm
