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DMST ABD 3 > Cystic Structure > Flashcards

Cystic Structure Flashcards

1
Q

What is a cyst?

A

Walled off collection of fluid

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2
Q

What defines a true cyst? 2

A
  1. Epithelial lining
  2. Congenital
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3
Q

What defines a acquired cyst? How does it form? 3

A
  1. No epithelial wall
  2. Trauma
  3. Infection
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4
Q

What are two types of congenital cysts? 2

A
  1. Hereditary
  2. Developmental
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5
Q

What determines infection in terms of acquired cysts? 2

A
  1. Parasitic symptoms
  2. Inflammatory - abscess
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6
Q

How can true cyst occur in organs? 2

A
  1. Multiple cysts in one organ
  2. Multiple organs with cysts
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7
Q

What questions helps determine a acquired cyst? 3

A
  1. History
  2. Signs
  3. Symptoms
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8
Q

Why is sonographic appearance important for cysts? 3

A
  1. Helps direct course of treatment for patient
  2. A simple cyst does not need follow up
  3. A complex cyst requires further testing or follow- up to rule out malignancies
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9
Q

How do we describe a simple cyst? 4

A
  1. Anechoic
  2. Strong back wall
  3. posterior acoustic enhancement
  4. Oval or round (refractive edge shadow)
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10
Q

How would we describe a complex (atypical) cysts? 4

A
  1. Internal echoes
  2. Septations
  3. Calcifications
  4. Thick wall or mural nodularity
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11
Q

What does age do for cysts?

A

Increase the occurrence

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12
Q

Which organs does cysts increase in odds for in terms of occurrence?

A

Liver and kidneys

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13
Q

Cysts are a common find during what type of scan?

A

Abdominal scan

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14
Q

Cysts can be what kind of finding on a scan?

A

Incidental finding

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15
Q

Finding several cysts in a patient can indicate what?

A

Genetic abnormality

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16
Q

How would a cyst affect a patient? 6

A
  1. It can be asymptomatic
  2. Pain
  3. Pressure
  4. Increased lab values
  5. Jaundice
  6. Fever
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17
Q

In terms of how a cyst can affect a person, what can it be dependent on? 3 (what are things that affect how they affect someone)

A
  1. Number
  2. Size
  3. Location
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18
Q

What are the two main categories of renal cortical cyst?

A

Simple and complex

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19
Q

Are simple renal cortical cysts benign?

A

Yes

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20
Q

What is the pathogenesis of simple renal cortical cysts? ( Etiology)

A

Unknown

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21
Q

What is the incidence rate in correlation with age for simple renal cortical cysts?

A

They increase with age

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22
Q

What demographic typically is affected by simple renal cortical cysts?

A

Found in 50% of people over the age of 50

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23
Q

Are simple renal cortical cysts symptomatic?

A

They are mostly asymptomatic

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24
Q

What happens if we find a simple renal cortical cyst?

A

They require no follow up

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25
Q

What happens if we see complex renal cortical cysts?

A

Typically they require further imaging with CT

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26
Q

What would we see that would typically determine if a renal cortical cyst is complex? 2

A
  1. If septations are irregular and >1mm in thickness
  2. Solid elements are present
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27
Q

In terms of a complex renal cortical cysts, when would we consider the lesion non malignant?

A

Until it is proven otherwise

basically it is a good idea to interrogate the cyst with colour until and watch for colour flow

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28
Q

What do these images represent?

A

Simple renal cortical cysts

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29
Q

What do these images represent?

A

Complex renal cortical cysts

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30
Q

What does polycystic kidney cysts mean?

A

cysts that you are born with

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31
Q

What are the two types of polycystic kidney disease?

A
  1. Autosomal dominant
  2. Autosomal recessive
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32
Q

Which type of polycystic kidney disease is most common?

A

Autosomal dominant polycystic kidney disease

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33
Q

When does autosomal dominant PKD general manifest?

A

In the 4th decade of life (40s)

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34
Q

What are some associated anomalies of autosomal dominant PKD? (What organ systems it gets affects) 4

A
  1. Liver
  2. Pancreas
  3. Splenic cysts
  4. Cerebral berry aneurysms
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35
Q

50% of patients with Autosomal dominant PKD develop what?

A

Renal failure

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36
Q

What signs and symptoms does autosomal dominant PKD usually present with? 5

A
  1. Palpable mass
  2. Pain
  3. Hematuria
  4. Hypertension
  5. UTIs
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37
Q

What does Autosomal dominant PKD look like sonographically? 2

A
  1. Renal enlargement
  2. Multiple cysts bilaterally
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38
Q

Where does the multiple cysts present sonographically for autosomal dominant PKD? 2

A
  1. Cortical
  2. Medullary
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39
Q

What does this image demonstrate?

A

Autosomal dominant PKD

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40
Q

What are four types of autosomal recessive PKD?

A
  1. Perinatal
  2. Neonatal
  3. Infantile
  4. Juvenile
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41
Q

What abnormalities are more prominent in young children for autosomal recessive PKD?

A

Renal abnormalities are more prominent

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42
Q

What abnormalities are more prominent in older children in terms of autosomal recessive PKD?

A

Liver abnormalities - portal hypertension

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43
Q

All cases of ARPKD are associated with what?

A

Congenital hepatic fibrosis

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44
Q

What does Autosomal recessive polycystic kidney disease look like sonographically? 3

A
  1. Massively enlarged echogenic kidneys
  2. Loss of CM differentiation
  3. Macroscopic cysts noted occasionally
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45
Q

What does this image demonstrate? Why?

A

Autosomal recessive polycystic kidney disease

Note the following
1. Massively enlarged echogenic kidneys
2. Loss of CM differentiation
3. Macroscopic cysts noted occasionally

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46
Q

Where do parapelvic cysts originate likely?

A

Lymphatic origin

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47
Q

Where are parapelvic cysts located?

A

In the renal sinus

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48
Q

Are parapelvic cysts symptomatic or asymptomatic?

A

Mostly asymptomatic

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49
Q

What is the sonographic appearance of parapelvic cysts?

A
  1. Well defined
  2. Do no connect with the collecting system
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50
Q

What tests do we do to differentiate between multiple parapelvic cysts and hydronephrosis?

A

IVP or contrast CT

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51
Q

What are these images demonstrating?

A

Parapelvic cysts

52
Q

What are medullary sponge kidneys?

A

Kidneys with dilated (ectatic) collecting tubules

53
Q

What is the etiology of medullary sponge kidneys?

A

Etiology is unknown

54
Q

When does medullary sponge kidneys manifest?

A

3rd and 4th decade

55
Q

Medullary sponge kidneys is found in 12% of patients with what?

A

Stones

56
Q

What is the sonographic appearance of medullary sponge kidneys? 2

A
  1. Bilaterally echogenic pyramids
  2. Calcs may be present - localized to pyramids
57
Q

What does these images demonstrate?

A

Medullary sponge kidneys

58
Q

Medullary cystic diseases are a result of what typically?

A

Progressive renal tubular atrophy

59
Q

Are medullary cystic disease genetic disorders?

A

Yes, Both recessive and dominant forms

60
Q

What does medullary cystic disease look like sonographically?

A

Small echogenic kidneys with cysts (0.1 - 1cm) at the pyramids

61
Q

What is the most common renal cyst disease in children?

A

Multicystic dysplastic kidneys

62
Q

Are multicystic dysplastic kidneys a genetic disorder?

A

No, therefore it is a nonhereditary disease

63
Q

When does multicystic dysplastic kidneys usually occur?

A

Developmental phase (obstruction of ureter in utero)

64
Q

In terms of demographic what demographic does mutlicystic dysplastic kidneys affect?

A

Both males and females, right and left equally affected

65
Q

What does multicystic dysplastic kidneys look like? 3

A
  1. Small kidney
  2. Malformed with multiple non communicating cysts
  3. Absence of normal architecture
66
Q

Multicystic dysplastic kidneys are generally __________? Which side(s) affected

A

Unilateral

67
Q

If multicystic dysplastic kidneys are bilateral what happens? Where do we generally see this?

A
  1. It is incompatible with life
  2. In utero
68
Q

Primary congenital cysts are also called what?

A

Epidermoid cysts

69
Q

Primary congenital cysts affect what organ?

A

SPleen

70
Q

How common are primary congenital cysts?

A

Rare

71
Q

What is the echogenic cystic structure of primary congenital cysts? And are they symptomatic or asymptomatic?

A
  1. Internal echoes
  2. Asymptomatic
72
Q

When we see primary congenital cysts what can be noted about them in terms of amount?

A

They are typically solitary

73
Q

Which geographic demographic is generally affected by choledochal cysts?

A

Eastern Asia

74
Q

Which demographic of people are affected by choledochal cysts?

A

Females

75
Q

What organ does the choledochal cysts affect?

A

CBD

76
Q

How does Choledochal cysts affect the CBD? (How does it look?)

A

Fusiform dilation of the CBD

77
Q

Where does the choledochal cysts insert into?

A

Anomalous insertion of CBD into pancreatic duct

78
Q

What tumors is choledochal cysts known to be associated with?

A

Cholangiocarcinoma

79
Q

What kind of structure is the choledochal cysts?

A

It is a cystic structure

80
Q

The choledochal cysts may contain what? 3

A
  1. Sludge
  2. Stones
  3. Solid neoplasm
81
Q

If the choledochal cysts is large, it may difficult to identify the connection to what?

A

Bile duct

82
Q

Which type of choledochal cysts is the most common?

A

Type 1 is the most common, the one with the fusiform dilation of the extrahepatic duct

83
Q

What does this image represent?

A

Choledochal cysts

84
Q

How common is Caroli’s disease?

A

It is rare

85
Q

What type of disease is Caroli’s disease?

A

Congenital

86
Q

How does Caroli’s disease present? (What does it look like?)

A

Dilation of the intrahepatic biliary tree

87
Q

What does Caroli’s disease result in? 4

A
  1. Stasis
  2. Stones
  3. Cholangitis
  4. Sepsis
88
Q

What does Caroli’s disease look like sonographically? 2

A
  1. Saccular or fusiform dilation of the intrahepatic bile duct
  2. Diffuse but may be focal
89
Q

What is the most common presentation of Caroli’s disease sonographically? (shape wise)

A

Saccular

90
Q

What does the dilated ducts of Caroli’s disease contain?

A

Stones and sludge

91
Q

What does this image represent?

A

Caroli’s disease

92
Q

What kind of disease is cystic fibrosis? (genetic, congenital, acquired etc.)

A

Genetic

93
Q

What kind of dysfunction is cystic fibrosis?

A

Exocrine

94
Q

What does cystic fibrosis look like sonographically? 2

A
  1. Increased echogenicity
  2. Atrophy
95
Q

What is seen with cystic fibrosis?

A

Small cysts (1-3 mm) on pathology but are uncommonly seen sonographically

96
Q

What are two types of cysts seen with the peritoneum?

A

Inclusion cysts and mesenteric cysts

97
Q

The fluid in the inclusion cysts are produced by what? What are they usually absorbed by?

A
  1. Active ovaries
  2. Usually absorbed by the peritoneum
98
Q

The fluid balance of inclusion cysts can be upset by what? 5

A

Diseases that cause adhesions

  1. Surgery
  2. Trauma
  3. PID
  4. IBD
  5. Endometriosis
99
Q

When adhesions trap ovarian fluid, what happens over time?

A

Inclusion cysts are formed encasing the ovary

100
Q

What are mesenteric cysts?

A

Rare intra-abdominal masses

101
Q

Mesenteric cysts are typically what kind of finding?

A

Incidental finding

102
Q

What is the origin of mesenteric cysts typically? 2

A
  1. Lymphatic
  2. Mesothelial orgin
103
Q

What is the size of mesenteric cysts?

A

Variable (<1 - >25cm)

104
Q

Are mesenteric cysts simple or complex cysts?

A

May be both

105
Q

What are duplication cysts filled with?

A

Anechoic fluid

106
Q

What does duplication cysts look like?

A

Well defined, double layer wall

107
Q

What does the walls of the duplication cysts look like?

A
  1. Inner echogenic mucosal layer
  2. Outer hypoechoic muscular layer
108
Q

What does the double wall of duplication cysts help do?

A

Help distinguish this particular type of cysts from mesenteric cysts?

109
Q

What is this cysts?

A

Duplication cyst

110
Q

What are the two types of prostatic cysts?

A
  1. Degenerative
  2. Congenital
111
Q

What is the most common kind of prostatic cyst?

A

Degenerative

112
Q

Where are degenerative cysts generally located?

A

Transitional zone

113
Q

What is the clinical significance of degenerative prostatic cysts?

A

No clinical significance

114
Q

Are congenital prostatic cysts symptomatic or asymptomatic?

A

Mostly asymptomatic

115
Q

What is congenital prostatic cysts associated with?

A

Infertility and hematospermia (blood in seminal fluid)

116
Q

What are four kinds of prostatic cysts?

A
  1. Utricle cysts
  2. Mullerian duct cysts
  3. Ejaculatory duct cysts
  4. Seminal vesicle cysts
117
Q

Describe utricle cysts in terms of association

A

Unilateral renal agenesis association

118
Q

Where are utricle cysts located?

A

Always midline

119
Q

What is the shape of utricle cysts?

A

Teardrop shape

120
Q

What is the shape of mullerian duct cysts?

A

Teardrop shape with a thick wall

121
Q

What is Mullerian duct cysts completely void of?

A

Spermatozoa

122
Q

What kind of structure is ejaculatory duct cysts and what is it associated with? 2

A
  1. Fusiform structure
  2. Infertility
123
Q

What is seminal vesicle cysts associated with?

A

Ipsilateral renal agenesis

124
Q

What should lab test values be for cysts?

A

Lab test could be abnormal

125
Q

What are some lab test we would look for in terms of cysts? 2

A
  1. LFT
  2. WBC
126
Q

What are four treatment methods for cysts?

A
  1. Aspiration
  2. Alcohol ablation
  3. Surgical removal
  4. Organ transplant
127
Q
A

DMST ABD 3 (11 decks)

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