GI Section III: Liver masses (USD rapid review) Flashcards
Anechoic with well defined, thin walls. Single or multiple - less than 2 cm.
Cysts
Things to suggest maybe it’s not a cyst and instead possibly a parasite (i.e. Hydatid)?
- Bigger than 2 cm.
- Presence of membranes.
- Abundant sediment in cysts.
Most common liver tumor.
Hemangioma
Hemangioma
well defined, homogeneously echogenic. No intemal doppler flow (because it is a slow flow lesion).
Will see posterior enhancement (because like a cyst, the blood is just slow flowing, so the signal passes through it quickly.)
Things to suggest maybe it’s not a hemangioma
Intemal flow
Young woman - most classic
Seen after chemotherapy treatment with oxaliplatin (chemotherapy for bowel cancer) Can occur with other lesions
(most commonly hemangioma)
Focal Nodular Hyperplasia
Focal nodular hyperplasia
Isoechoic to the liver and very difficult
to see - so they must either show the lesion;
* Bulging the liver,
* Presence o f a central scar, or
* Classic spoke wheel appearance on doppler.
Anabolic hormones/oral contraceptives intake + Glycogen storage disease + Being a fat ass with diabetes
Hepatic Adenoma
Hepatic Adenoma
Round mass with well defined borders.
Hypoechoic halo of fatty sparing.
**Appearance is highly variably because of hemorrhage, fat, calcification, necrosis
Hepatic Adenoma
Classic Doppler: perilesional increased flow (although this is also variable)
Hepatocellular Carcinoma
A thin peripheral halo of hypoechogenicity can represent either focal fatty sparing (in the case of an Adenoma) or… a fibrous capsule (target) as is often seen in HCC - so this should also be conceming.
Basically anything with a shit ton of intemal flow or peripheral flow on Doppler (other than your typical spoke wheel pattern o f FNH) you gotta be worried.
Hepatocellular Carcinoma
Multiple lesions -
Especially if there is a halo (target sign).
Mets
