Benign Neoplastic Diseases Flashcards
What type of estrogen exposure affects a hemangioma?
HRT or pregnancy (BCP dose too low)
size of a liver hemangioma
typically up to 3 cm
gender prevalence of a hemangioma
females>males
appearance of liver hemangioma
small, homogeneous, hyperechoic, well-defined
may exhibit necrotic or degenerative central area
vascularity of hemangioma
often too slow to pick up
Characteristics of benign neoplasms
asymptomatic and do not often alter lab tests
hypo/avascular
well-defined and encapsulated
slow growing
Identify: small, benign, homogeneous, hyperechoic, well-defined liver mass, may have central hypoechoic/anechoic area, vascularity too slow to pick up
liver hemangioma, lipoma
What tests could be performed to confirm diagnosis of a hemangioma?
MRI, CT, red blood cell scintigraphy - hot due to capillary bed
What follow up is suggested for a liver hemangioma?
serial ultrasounds
Common echogenicity of benign liver neoplasms
hyperechoic
What is focal nodular hyperplasia?
proliferation of growth of normal liver cells in an abnormal arrangement (non-hexagonal)
What is the functional unit of the liver?
lobule
What are the components of a liver lobule?
hepatocytes, canaliculi, venous sinuses, Kupffer/reticuloendothelial cells
gender prevalence of FNH
women>men
size of FNH
up to 8 cm
vascularity of FNH
some central flow
appearance of FNH
small-med size, homogeneous, isoechoic, well-defined liver mass, hypoechoic central scar
What test(s) could be performed to confirm diagnosis of FNH?
sulphur colloid scan - FNH is warm or hot because of increased density of Kupffer cells
What is the most common benign liver neoplasm?
hemangioma
liver “stealth lesion,” aka
FNH
What follow up is suggested for a FNH?
serial ultrasounds
Identify: small-med size, benign, homogeneous, isoechoic, well-defined liver mass, central vascularity, hypoechoic central area, influenced by estrogen
FNH
benign liver neoplasm that is affected by estrogen
hemangioma and FNH
What two benign liver neoplasms can a sulphur colloid scan differentiate?
FNH - warm or hot
liver adenoma - cold
size of liver adenoma
8-15 cm
appearance of liver adenoma
variable echogenicity (usually hyper), well defined and encapsulated, solitary mass
vascularity of liver adenoma
central flow
What follow up is suggested for a liver adenoma?
surgical removal due to risk of hemorrhage and infarct
Which benign liver neoplasm is linked to use of oral contraceptives and Type 1 Glycogen Storage Disease?
liver adenoma
Type 1 Glycogen Storage Disease, aka
von Gierke’s disease
What test can be performed to confirm diagnosis of liver adenoma?
sulphur colloid scan would be cold - lack Kupffer cells
Identify: large, variable echogenicity (usually hyper), well defined and encapsulated, solitary mass, central vascularity
liver adenoma
appearance of lipoma
homogeneous, hyperechoic, well-defined liver mass, may have central hypoechoic/anechoic area
liver hemangioma, aka
cavernous hemangioma
most common benign splenic neoplasm
hemangioma
size of splenic hemangioma
variable: S -> L
appearance of splenic hemangioma
variable - hyperechoic, homogeneous and solid, or complex with cystic degeneration
What is a hemangioma?
cluster of blood capillaries
vascularity of splenic hemangioma
absent or low, flow too slow
name two rare benign splenic neoplasms
hamartoma, lymphangioma
suggested follow up for splenic hemangioma
further testing to rule out malignancy
appearance of a hamartoma
echogenic, solid, homogeneous, NON-ENCAPSULATED
What do a hamartoma and lymphangioma have in common?
lymphoid origin from spleen
appearance of lymphangioma
variable, solid or cystic
What is cystic lymphangiomyomatosis?
multiloculated cystic lymphangioma
multiloculated cystic version of lymphangioma
lymphangiomyomatosis
normal GB wall thickness
3 mm
appearance of GB adenoma
small-mid size, hyperechoic, homogeneous, pedunculated
size of benign GB adenoma
up to 10 mm
vascularity of GB adenoma
avascular or hypovascular
Identify: small-mid size, hyperechoic, homogeneous, pedunculated GB mass, hypo/avascular
GB adenoma, cholesterolosis, or cholesterol polyp
cholesterolosis
multiple non-shadowing masses attached to GB wall
multiple non-shadowing masses attached to GB wall
cholesterolosis
What is adenomyomatosis?
cholesterol trapped within exaggerated RA sinuses, and proliferation of the smooth muscle within the GB wall
appearance of adenomyomatosis
hyperechoic foci in a thickened GB wall, exhibiting comet-tail artifact
appearance of adenomyoma
focal, mass-like accumulation of adenomyomatosis
most common location of adenomyomatosis
GB fundus
appearance lent to GB by of mid-level adenomyomatosis
hourglass shape
exocrine pancreatic cells
acini cells - produce digestive enzymes that drain into duodenum through pancreatic duct
endocrine pancreatic cells
Islets of Langerhans - secrete insulin and other hormones
most common pancreatic neoplasm
Islet cell tumour
most common type of Islet cell tumour
Insulinoma
typical location of insulinoma
pancreatic body or tail
non-functioning Islet cell tumour
less common (15%), more commonly malignant
functioning Islet cell tumour
more common (85%), usually benign
appearance of Islet cell tumour
variable size, hypoechoic, solid, well-encapsulated,
AML
angiomyolipoma
angiomyolipoma, aka
renal hamartoma
renal hamartoma, aka
angiomyolipoma
gender prevalence of AML
middle-aged women
appearance of AML
unilateral, hyperechoic, homogeneous, well defined, in peripheral renal cortex (may be exophytic)
vascularity of an AML
hypo/avascular, flow too low
Identify: unilateral, hyperechoic, homogeneous, well defined, hypo/avascular mass in peripheral renal cortex
AML/renal hamartoma or renal cell carcinoma
Which benign neoplasm is associated with tuberous sclerosis?
AML/renal hamartoma
size of renal adenoma
up to 3 cm
size of oncocytoma
greater than 3 cm
gender prevalence of renal adenoma/oncocytoma
male>females
age prevalence of renal adenoma/oncocytoma
60’s-70’s
appearance of renal adenoma/oncocytoma
hypoechoic (sometimes isoechoic), well-defined mass in renal cortex
Identify: hypoechoic (sometimes isoechoic), well-defined mass in renal cortex
renal adenoma/oncocytoma, renal cell carcinoma, or dromedary hump (if pyramids seen)
appearance of adrenal adenoma
solid, round, unilateral, hypoechoic, encapsulated, may contain calcs
normal echogenicity of adrenals
thin echogenic medulla, hypoechoic cortex
zones of adrenal cortex
zona glomerulus, zona fasciculata, zona reticularis
hormones secreted by adrenal cortex
steroids (aldosterone, cortisone, estrogens, androgens
diseases associated with a hyperfunctioning adrenal adenoma
Cushing’s syndrome, Conn’s disease
hyperfunctioning adrenal adenoma vs non-functioning
both may be benign, but non-functioning is more common
name two non-functioning benign adrenal neoplasms
adrenal adenoma and myelolipoma
name two hyperfunctioning benign adrenal neoplasms
adrenal adenoma and pheochromocytoma
name two cortical benign adrenal neoplasms
adrenal adenoma and myelolipoma
medullary benign adrenal neoplasm
pheochromocytoma
origin of pheochromocytoma
adrenal medulla
origin of myelolipoma
zona fasciculata of adrenal cortex
origin of adrenal adenoma
adrenal cortex
gender prevalence of myelolipoma
males = females
appearance of myelolipoma
small-mid size, hyperechoic
Which benign adrenal neoplasm causes propagation speed artifact?
myelolipoma (fatty component)
size of myelolipoma
up to 5 cm
symptoms of pheochromocytoma
elevated catecholamines in urine, HTN, palpitations, tachycardia, excessive sweating
age prevalence of pheochromocytoma
40’s-50’s
age prevalence of myelolipoma
50’s-60’s
Which adrenal gland is more commonly afflicted with a pheochromocytoma?
right side
size of pheochromocytoma
greater than 2 cm
appearance of pheochromocytoma
solid, unilateral, encapsulated, hypoechoic, may be either homo or heterogeneous
Which benign adrenal neoplasm is associated with tuberous sclerosis and MEN syndrome?
pheochromocytoma
MEN syndrome
multiple endocrine neoplasia syndrome
tuberous sclerosis
genetic condition exhibiting mental retardation, seizures, sebaceous tumours
syndrome associated with “fits and zits”
tuberous sclerosis
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
Identify: small-mid size, hyperechoic adrenal cortical mass, causing propagation speed artifact
myelolipoma
most common benign abdominal wall neoplasm
desmoid tumour
desmoid tumour location
connective tissue, usually anterior abdominal wall, at a previous surgical or laparoscopic site
Which surgery is commonly associated with developing a Desmoid tumour?
C-section
gender prevalence of Desmoid tumour
females>males
age prevalence of Desmoid tumour
20’s-30’s (reproductive age)
appearance of Desmoid tumour
homogeneous and hypoechoic, local infiltration
Identify: homogeneous and hypoechoic mass in anterior abdominal wall, local infiltration, at site of previous surgery
Desmoid tumour
appearance of lipoma
mild to highly hyperechoic
features of a benign lipoma
mobile, compressible
Identify: hyperechoic lesion in the abdominal wall, mobile, compressible
lipoma
appearance of microcystic pancreatic neoplasm
well-defined, multiple small cysts - may appear solid and hyperechoic due to multiple cystic interfaces
size of microcystic pancreatic neoplasm
less than 2 cm
most common location for microcystic pancreatic neoplasm
pancreatic head
microcystic pancreatic neoplasm, aka
pancreatic serous cystadenoma
pancreatic serous cystadenoma, aka
microcystic pancreatic neoplasm
