Focal Lesions

Question 1

Hemangioma
- what
- gender
- symptoms
- diagnosis
- treatment

Answer 1

• benign liver tumouts
• more common in females
• none
• USS
• none

Question 2

Focal Nodular Hyperplasia
- what
- appearance on imaging
- commonly seen in who?
- histology appearance

Answer 2

• benign nodule formation of normal liver tissue
• central scar containing large artery, radiating to branches to periphery (Hub and spooke)
• young and middle aged woman
• sinusoids, bile ductles and Kupferr cells
• usually US diagnosis + no treatment

Question 3

Hepatic Adenoma
- appearance
- common in which gender
- what is this associated with?
- symptoms
- usually in which liver lobe?
- diagnosis
- treatment

Answer 3

• no portal tract, central veins or bile ducts and has normal hepatocytes
• more common in woman
• contraceptive hormones + anabolic steroids
• asymptomatic but may have RUQ pain
• right
• diagnosis: US filling defect
• males: surgical excision due to possibility of malignant transformation
• females: do imaging after 6 months:
• if less than 5 cm or reducing in size –> annual MRI but if more than 5 cm or increasing in size then surgery

Question 4

for cysts refer to focal lesion lectures of WEEK 4 GI

Question 5

slide 32 onwards from focal lesion lectures

Answer 5

• malignancy

Question 6

Liver abscess
- symptoms
- any specific history
- management

Answer 6

• high fever, leukocytosis, abdominal pain, complex liver lesion
• abdominal or biliary infection, dental procedure
• 4 week broad spectrm antibiotics with imaging, then aspiration, echocardiogram

Question 7

answers in lecture slides from 33 onwards

HCC
- which gender is it more common in?
- risk factor
- symptoms
- where can it metastasise to?
- **how is it diagnosed **
- treatment - what is the criteria
- what is the treatment if pt has early cirrhosis
- what is the first line treatment for advanced HCC?

Answer 7

diagnosis:
- AFP is a tumour marker
- values higher than 100ng/ml highly suggests HCC
- US

Question 8

Fibro-lamellar carcinoma
- who does this often present in?
- how are the AFP levels?
- is it related to cirrhosis?
- what does CT scan show
- standard care?