Common Small Parts Pathology Test Flashcards
appearance of benign lesions of the breast
smooth rounded edges do not invade surrounding tissue rounded or oval long axis parallel to the chest wall isoechioc with normal breasat tissue
appearance of malignant lesions of the breast
irregular walls often spiculated margins which are finger like extensions extending out in numerous directions from the mass disrupt normal breast tissue and cause nipple retraction and skin dimpling due to pulling on coopers ligament sharp angular margins microlobulations taller tan wide hypoechoic with weak internal echoes
most common benign breast tumor
fibroadenoma growth stimulated with estrogen develop due to failure of the fibrous and epithelial cells to regress during the 2nd 1/2 of the menstrual cycle
appearance of fibroadenoma
large rounded lobulations oval, homogenious, wider than tall
appearance of malignant lymph node
changes from oval to round echogenic hilum becomes more difficult to detect same shape when you turn on it
most frequent cause of hyperthyroidism
graves disease
graves disease affects
women over 30
appearance of graves disease
hypoechoic gland with diffuse enlargement no discrete nodules intense color doppler-thyroid storm inferno
patient with graves disease
bulging eyes agitation weight loss
treatment of graves disease
radioactive ablation with lifelong supplements of sinthroid
most common form of thyroiditis
hashimoto’s disease
hashimoto’s disease
affects middle aged women autoimmune disorder
appearance of hashimoto’s disease
enlarged homogeneous hypoechic thyroid texture discrete nodules less common acute stage has less vascularity chronic stage will have increased color doppler when TSH elevates atrophic stage depicts small, heterogeneous gland that is hypovasvular
appearance of thyroid adenoma
variable size homogenous not necessarily associated with thyroid enlargement range from anechoic to hyperechoic commonly have a peripheral halo hyperfunctioning adenomas can have increased blood flow
appearance of mutinodular goiter (nodular hyperplasia)
variable sonographic appearance, usually enlarged, irregular, nodular, heterogeneous,and often not symmetrical most have similar appearance to thyroid adenomas, including halos and homogenous echogenicity nodules may also have cystic areas, calcifications an colloid cyst formation
most common thyroid abnormality
nodular hyperplasia (multinodular goiter)
most common benign tumor of the liver
cavernous hemangioma usually asymptomatic and discovered incidentally
appearance of cavernous hemangioma
hyperechoic and typically has posterior enhancement usually the right lobe and near the dome
2nd most common benign mass of the liver
focal nodular hyperplasia women under 40 and asymptomatic
appearance of focal nodular hyperplasia
most in right lobe hyper to iso echoic many have central scar
an acguired diffuse disorder resulting in an accumulation of triglycerides with the hepatocytes
fatty liver/fatty sparing
appearance of fatty liver/fatty sparing
not always uniform and can present focal fatty liver (patchy distibution) focal sparing (mass like hypoechoic regions in and echogenic liver) often near the GB @ the porta hepatis, caudate lobe, and left lobe
most important in making diagnosis of fatty liver
liver echogenicity compared to right kidney
congenital varient of liver
riedels lobe
appearance of riedels lobe
anterior projection of the liver extending to near the iliac crest not merely an elongated inferior posterior segment extending over the right kidney
most common cancerous mass of the liver
metastatic disease
metastatic disease of the liver most commonly from
GI including GB and pancreas, breast, and lung
appearance of metastatic disease of liver
hyperechoic, hypoechoic, bulls eye, calcified, cystic, diffuse
primary metastatic desease of the liver
hepatocellular carcinoma common in men associated with w/ chronic cirrhosis and Hep B and C
appearance of hepatocellular carcinoma
isoechoic with halo, cotton balls, or can loot like lots of cysts
accumulation of serous fluid in the peritoneal cavity
ascites
appearance of ascites
echo free fluid regions indented and shaped by the surrounding organs 1st fills pouch of douglas before is ascend to the paracolic gutters, major flow from the pelvis is via the right side small bowel loops sink and float within the fluid
occur in 5% of people over the age 50 often seen in patients with autosomal dominant polycystic kidney desease
hepatic cysts or liver cysts (IDK)
appearance of liver cyst
smooth, thin, well defined walls round or oval anechoic increased posterior enhancement (though transmission) single or numerous
irregular, hypoechoic lesion, dilated pancreatic duct, liver and para-aortic nodes
pancreatic adenocarcinoma most often in head and usually cause obstruction of CBD, GB, and hydrops and jaundice
symptoms of pancreatic adenocarcinoma
ABD pain back pain painless jaundice weight loss
pancreas appears inflamed and releases enzymes into the surrounding pancreatic tissue. Hypoechoic and edematous with irregular borders. Pancreatic duct may become enlarged
acute pancreatitis
pancreas appears hyperechoic with echogenic foci andomly dispersed throughout the gland
chronic pancreatitis
an accumulation of pancreatic fluid and necrotic debris confined by the retroperitoneum
pseudocysts
common causes of pseudocysts
acute pancreatitis chronic panreatitis pancreatic trauma pancreatic ductal obstruction pancreatic neoplasms
most common cause for pseudocysts in children
ABD trauma
focal lesions in the spleen resulting from previous infections
splenic calcifications (granulomatous infection)
appearance of granulomatous infection (splenic calcifications)
bright echogenic lesions with or without shadowing
most common cause of spenic calcifications (granulomatous infections)
tuberculosis and histoplasmosis
common congenital anomaly of the spleen
accessory spleen
appearance of accessory spleen
well circumcised typically rounded and isoechoic with the spleen typically found at the lower splenic pole or near the hilum
priminent infolding of the renal cortex which indents the renal medullary. Columns have an echogenicity similar to renal paenchyma and are continous with the renal cortex. Do not distort the renal cortex
column of bertin
bulge of the renal cortex that occurs on the lateral border of the kidney. more often on the left than the right. identical echogenicity as renal corted and can mimic a cortical tumor. Cortical border is intact and hump will contain normal appearing pyramid structures. Little bit of fat in hump
dromedary hump
developmental varient seen more in children and sometimes in adults. Typical smooth cortical border appears indented or undulated between the calyces, giving the kidney surface a lobulated appearance. Cortical borders are still intact and parenchymal thickness is uniform through kidney. Cases of renal scarring and/or insufficiency will demonstrate cortical thinning
fetal lobulation
on both the long and transverse images the central renal sinus appears as two echogenic regions that are separated by a cleft or normal renal tissue. On continuous transverse imaging one image will appear to have no central medullary tissue only parenchymal tissue.
duplex collecting system
triangular echogenic area in the upper pole of renal cortex. Not to be confused with angiomyolipoma which is a round echogenic parenchymal mass found anywhere within the renal parenchyma
junctional defect
renal pelvis portion of the collecting system extends outside of the confines of the central renal sinus. Appears as a central cystic area that is either partially or entirely beyond the confines of the kidney
extrarenal pelvis
most common renal problem
nephrolithiasis (kidney stone) more common in men
appearance of nephrolithiasis
echogenic foci with posterior acoustic shadowing stones within the cortex are easier to distinguish than stones within the medullary and prominent renal sinus. Fat with weak shadowing can mimic stones
Smooth thin well defined walls round or oval anechoic (low level echoes = artifact Vs pathology) increases posterior acoustic enhancement can be single or numerous, found anywhere in the kidney (exophoc, parenchymal, or medullary
simple cortacle renal cyst
cysts within the renal collecting system (medullary)
parapelvic cysts
appearance of parapelvic cysts
anechoic cyst located in the renal hilum will distort the renal sinus fat and does not communicate with the collecting system well defined but will have irregular borders caused from the compression of the adjacent renal sinus structures enlarge and cause renal obstruction
fluid filled separation of the renal sinus with an appearance that conforms to the calyces and renal
obstructive hydornephrosis
3 grades of obstructive hydronephrosis
1 small separation or splaying of the calyces 2 fluid extends into the major and minor calyces, bear claw effect, with minimal thinning of the cortex 3 massive dilation of the renal pelvis with significant loss of renal cortex
criteria for differentiating hydro from para pelvic cysts
renal dilation must have connecting calyces to by hydro important to follow the renal dilation as distal as possible in an attempt to determine the cause and location of the hydro
dilation of the renal sinus and pelvis without an actual blockage of the flow of urine into the bladder
nonobstructive hydronephrosis
common causes of nonobstructive hydronephrosis
an overly distended bladder UTI or extrinsic blockage of the ureters and or bladder from retroperitoneal adenopathy pelvic masses/uterine fibroids pregnancy enlarged prostate
what should you do when a dilation is noted
check for bilateral ureteral jets
