glandular calcifications Flashcards
what is gallstone aka?
cholelithiasis
are gallstones usually seen on film?
only 10-20% are radiopaque (positive) the rest are not seen
why aren’t gallstones typically seen on x-ray?
most made of cholesterol and the cholesterol composition can’t be seen
how can you tell in a gallstone is old or new?
old ones are laminated
like a tree, the older the stone, the more rings it has
how do gallstones typically present?
usually there are multiple stones with faceted (flat) surfaces and a peripheral rim of calcification
what are lucent internal branching cracks filled with nitrogen gas that may be seen internally called and why are they called that?
“mercedes benz” or “crow foot” sign due to their Y shape
what causes the mercedes benz/ crow foot sign?
old stones dehydrate and shrink
what quadrant are gallstones typically located?
RUQ
where would you see gallstones on a lateral film?
anterior to the spine
are gallstones typically symptomatic or asymptomatic?
asymptomatic 30-50% of the time
what size gallstone can pass through the ducts easily?
5mm or less
what are 3 causes a patient may experience pain from a gallstone?
1 recurrent cholecystitis
2 obstruction of a duct (usually cystic duct)
3 perforation of GB wall with fistula formation, usually onto duodenum or colon
gas found in the ducts as streaks of air are called?
pneumobilia
when a large stone causes bowel obstruction it is called what and where is it typically located?
usually in the terminal ileum
*gallstone ileus
what is a rare and worst case scenario associated with gallstones?
carcinoma
if the gallbladder lumen contains high % of Ca carbonate and appears very dense, what would you suspect?
milk of calcium bile-rare
what would upright films demonstrate with milk of calcium bile?
horizontal fluid level
porcelain or petrified gallbladder may be due to?
chronic cholecystitis
a thin linear calcification in the muscular wall or submucosal layer of the gallbladder is known as?
porcelain or petrified gallbladder
what is the shape of a porcelain/petrified gallbladder?
pear shaped, oval or round
porcelain gallbladder has what type of obstruction?
cystic duct obstruction and may not be visible
carcinoma occurs in what percent of porcelain gallbladder cases?
20%
what is the usual treatment of porcelain gallbladder?
removal prophylactically
many punctate (stippled) densities form in the pancreatic duct, you would suspect?
pancreatic calcifications
how do pancreatic calcifications present?
75% on both sides of the spine, they cross the midline
what is usually the cause of pancreatic calcifications?
chronic inflammatory process (chronic pancreatitis);
almost always found in chronic alcoholics (6+ years) (chronic pancreatitis)
what are other more rare causes of pancreatic calcification?
1 chronic calcifying pancreatitis 2 nutritional pancreatitis 3 HPT 4 cystic fibrosis 5 hereditary
rarely pancreatic calcifications are cystic (usually pseudocysts)
adrenal gland calcifications are located where?
paraspinally at about L1
where are adrenal gland calcifications seen on the lateral view?
over the spine like the kidneys
patterns of adrenal gland calcification are?
punctuate and cystic
adrenal gland calcification’s etiology?
can be benign or malignant
what type of adrenal calcification is often seen in children?
neonatal hemorrhage-punctuate
what is the adrenal calcification pattern seen with post traumatic hemorrhage in adults?
punctuate and cystic
what is the adrenal calcification pattern seen with TB and histoplasmosis?
punctuate but TB can be cystic too
31% of cortical malignancies contain what?
calcium
lymph node calcifications commonly originate from?
post infectious granulomas
how do lymph node calcifications appear?
small solid calcifications that are clumped into clusters
- mulberry like
- often multiple but can be singular
where are lymph node calcifications seen on an AP film?
close to the psoas muscles on AP film
what are the most common calcific abdominal lymphatics?
mesenteric nodes
where are mesenteric calcifications seen on a lateral film?
anterior to the spine
which lymph node calcification is close to the spine at about L2-L4 and is rare?
para-aortic node calcification
what are all lymph node calcifications caused by?
healed infections, most all from TB
are lymph node calcifications clinically significant?
no, all are thought to be insignificant
what is the MC location of lymph node calcifications?
hilar region of the chest
