Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

GI > Focal Lesions in the Liver > Flashcards

Focal Lesions in the Liver Flashcards

1
Q

Solid liver lesions in older patients are most likely to be malignant metastases. TRUE/FALSE?

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Solid liver lesions found in patients with chronic liver disease (such as Hepatitis or cirrhosis) are more likely to be Primary cancers. TRUE/FALSE?

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the most common solid liver tumour in non cirrhotic patients?

A

Haemangioma (benign)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Give examples of benign focal lesions in the liver

A

Haemangioma
Focal nodular hyperplasia
Adenoma
Liver cysts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What malignant cancers can arise in the liver?

A
  • Hepatocellular carcinoma
  • Cholangiocarcinoma
  • OR Metastases
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the appearance of a haemangioma and who usually gets these lesions?

A
  • Usually single, small and well demarcated capsule
  • Hypervascular
  • Females> males but often present at autopsy
  • Patients are usually asymptomatic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do haemangiomas appear on scans?

A

US: echogenic spot, well demarcated
CT: venous enhancement from periphery to centre
MRI: high intensity area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Haemangiomas need treated. TRUE/FALSE?

A

FALSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is follicular nodular hyperplasia and how does it look?

A
  • Benign nodule
  • May be due to a Congenital vascular anomaly;
  • Looks like a central scar containing a large artery, radiating branches to the periphery
  • Hyperplastic response to abnormal arterial flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What signs on histology indicate Follicular Nodular Hyperplasia?

A
  • Sinusoids
  • Bile ductules
  • Kupffer cells present on histology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Who normally experiences Follicular Nodular Hyperplasia? How do these patients present?

A
  • More common in young and middle age women

- Usually asymptomatic, may present with minimal pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does Follicular Nodular Hyperplasia appear on scans?

A

US: Nodule with varying echogenicity
CT: Hypervascular mass with central scar
MRI: Iso/Hypo-intense
FNA: Normal hepatocytes and Kupffer cells with central core

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Follicular Nodular Hyperplasia requires treatment. TRUE/FALSE?

A

FALSE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is a hepatic adenoma?

A
  • Benign neoplasm
  • composed of normal hepatocytes
  • NO portal tract, central veins or bile ducts involved in this lesion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What groups are at higher risk of a hepatic adenoma?

A
  • More common in women (female: male ratio 10:1)

- Associated with contraceptive hormones and anabolic steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

HOw do patients present with a hepatic adenoma?

A
  • Usually asymptomatic
  • May have RUQ pain
  • May present with rupture, haemorrhage, or malignant transformation (very rare)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Which gender is at higher risk of malignant change in a hepatic adenoma?

A

Malignant transformation risk higher in males

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What material do hepatic adenomas usually contain?

A

Fat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where in the liver are hepatic adenomas commonly found?

A

Right lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Multiple adenomas (adenomatosis) is associated with what other group of diseases?

A

Glycogen Storage Diseases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Hepatic adenomas can regress after contraceptive hormones are stopped. TRUE/FALSE?

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

HOw does a hepatic adenoma appear on a scan?

A

US: Filling defect
CT: Diffuse arterial enhancement
MRI: Hypo or hyper intense lesion
FNA: May be needed

23
Q

How can a hepatic adenoma be treated?

A
  • Stop hormones, weight loss
  • Males (due to malignant potential): surgical excision
  • Females: repeat imaging after 6months
    <5cm or reducing in size - annual MRI
    >5cm or increase in size - for surgical excision
24
Q

What are the two most likely solid liver lesions in young patients and how can we differentiate between them?

A

Adenoma

  • only hepatocytes involved
  • has malignant potential

Focal Nodular Hyperplasia

  • Contains all the liver ultrastructure
  • has a Central scar
25
Describe the appearance of a simple liver cyst
- Liquid collection lined by an epithelium - Not connected to biliary tree - Solitary - usually asymptomatic
26
How are simple liver cysts managed?
- No follow up necessary - If doubt, imaging in 3-6 mths - If symptomatic/ uncertain diagnosis, consider surgical intervention
27
How do Hyatid cysts usually present?
- disseminated disease | - erosion of cysts into adjacent structures/ vessels (IVC)
28
What regions are considered endemic for hyatid liver cysts?
- Eastern Europe - Central America - South America - Middle East - North Africa
29
How is a hyatid cyst managed?
Surgery: Most common (lobectomy may be used if emergency) Medical: Albendazole Percutaneous Drainage: PAIR
30
What are the potential risks of surgery for a hyatid cyst in the liver?
- Operative morbidity - anaphylaxis - dissemination of infection
31
What conditions can cause numerous cysts throughout liver parenchyma?
Polycystic Liver diseases: - Von Meyenburg complexes (Microhamartomas) - Polycystic Liver disease - Autosomal dominant Polycystic Kidney disease
32
What is the difference between Polcystic Liver disease and Autosomal Dominant Polycystic Kidney disease?
PLD: - Liver function preserved and renal failure rare - Symptoms depend on size of cysts - different genes (PCLD gene) ADPKD - Renal failure due to polycystic kidneys - Potential massive hepatic enlargement - different genes affected (PKD1 and PKD2)
33
What are the main clinical features seen if a patient has a liver abscess?
``` High fever Leukocytosis Abdominal Pain Complex liver lesion History of: – Abdominal or biliary infection – Dental procedure ```
34
How is a liver abscess managed?
- Empirical broad spec. antibiotics - Aspiration/drainage percutaneously - Echo - Operation if no clinical improvement (Open drainage/ Resection) - 4 weeks antibiotic therapy with repeat imaging
35
What is the most important risk factor for the development of hepatocellular carcinoma?
``` CIRRHOSIS caused by: - Hepatitis B/C - Alcohol - Aflatoxin ```
36
What are the presenting symptoms of HCC?
- Wt loss and RUQ pain (most common) - Some pts may be Asymptomatic - Worsening of pre-existing chronic liver disease - Acute liver failure
37
What signs of HCC can potentially be found on examination of a patient?
- Signs of cirrhosis - Hard enlarged RUQ mass - Liver bruit (rare)
38
Where else in the body can HCC metastasise to?
- Rest of liver - Portal vein - Lymph nodes - Lung - Bone - Brain
39
What tumour marker can be used in diagnosing HCC?
AFP (Alfa fetoprotein) - Values > 100ng/ml are highly suggestive of HCC - Elevation is seen in 60-80% of patients with HCC
40
What four factors dictate HCC prognosis?
- Tumour size - Extrahepatic spread - Underlying liver disease
41
When is a liver transplant used to treat HCC?
Only if single tumour <5cm | OR <3 tumours <3cm each
42
When would resection be used to treat HCC?
- For small tumours with preserved liver function | => (no jaundice or portal HT)
43
Why is liver transplantation a preferred treatment over resection for HCC?
With resection of liver, recurrence rate of HCC is still HIGH - If pt receives transplanted liver, recurrence rate is very low
44
When would local ablation be used for HCC?
- For non resectable pt - OR if pt has advanced liver cirrhosis - temporary measure only
45
What is chemoembolisation?
TransArterial ChemoEmbolization - TACE Inject chemotherapy selectively in hepatic artery Then inject an embolic agent Used in patients with early cirrhosis
46
Fibro-lamellar carcinoma is most common in which age group?
- Presents in young pt (5-35)
47
Firbo-lamellar carcinoma is related to cirrhosis. TRUE/FALSE?
FALSE - It is NOT related to cirrhosis
48
Describe the typical appearance of Fibro-Lamellar carcinoma
- stellate scar with radial septa
49
How is Fibro-Lamellar Carcinoma treated?
- Surgical resection - OR transplantation - TACE for patients with unresectable tumour
50
The liver is the most common site for blood borne metastases. TRUE/FALSE?
TRUE
51
What primary cancers commonly metastasise to the liver?
``` colon breast lung stomach pancreas melanoma ```
52
Describe the LFTs of a patient with secondary liver metastases
Mild cholestatic picture (ALP) | - BUT preserved liver function
53
How are liver metastases treated?
- Tx depends on primary cancer | - In some cases resection or chemoembolization is possible

GI (33 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions