Lesson 1C (Part 1) Flashcards
What is one of the most common malignant tumours?
Hepatocellular carcinoma
- HCC
Who is HCC more common in?
Men
- 5:1
What are the causes of HCC? (4)
- Alcoholic cirrhosis
- Viral Hep B&C
- Fatty liver-steatohepatitis-cirrhosis
- Fungi and toxins in food
What are symptoms of hepatocellular carcinoma?
- RUQ pain
- Weight loss
- Abdominal swelling
- ascites is present
What are 3 pathological forms of HCC?
- Solitary tumor
- Multiple nodules
- Diffuse infiltration
What does HCC sometimes invade?
The portal vein
- 30-60% of cases
Budd–Chiari syndrome
The condition is caused by occlusion of the hepatic veins that drain the liver
- is a very rare condition,
What is the sonographic appearance of HCC? (4)
- Hypoechoic, complex or echogenic
- Smaller nodules
- Thin peripheral hypoechoic halo
- fibrous capsule - Becomes more complex over time
What other testings can be done for HCC? (4)
- CEUS
- CT scan
- MRI
- Doppler
What is a subtype of HCC?
Fibrolamellar carcinoma
Who are fibrolamellar carcinoma more common in? (2)
- Adolescents
2. Young adults
What does fibrolamellar carcinoma coexist without?
A liver disease
What is recommended treatment for fibrolamellar carcinoma?
Surgical resection of the tumour
What is the sonographic appearance of fibrolamellar carcinoma? (2)
- Echogenicity is variable
- Calcification
- central echogenic scar distinguishes it from hepatomas of HCC
Hemagiosarcoma
Extremely rare malignant tumor
Who is more common to get hemagiosarcoma?
Adults 60-70 years of age
What is hemagiosarcoma associated with?
Carcinogens
What is the sonographic appearance of hemagiosarcoma?
Large mass of mixed echogenicity
Hepatic epitheloid
Rare malignant tumour of vascular origin
Who is more common to get hepatic epitheloid?
Adults
What are affected with hepatic epitheloid? (3)
- Soft tissues
- Lungs
- Liver
What is the sonographic appearance of hepatic epitheloid?
Multiple hypoechoic nodules
- large masses
Where are the most common primary tumours resulting in liver metastases from? (6)
- Gallbladder
- Colon
- Stomach
- Pancreas
- Breast
- Lung
What are 2 blood borne routes?
- Hepatic artery
2. Portal vein
What do lymphatics spread through? (4)
- Stomach
- Pancreas
- Ovary
- Uterus
Where do the tumour cells from the GI tract drain through to get to the liver?
Portal system
What is the sonographic appearance of mets? (5)
- Single or multifocal liver lesions
- All with identical sonographic morphology
- Diffuse liver involvement
- varied sized lesions - Geographic infiltration
- rarely - Hypoechoic halo
- strongly associated with malignancy
What is strongly associated with malignancy?
Hypoechoic halo
What are common echogenic sonographic patterns of metastatic disease? (7)
- GI tract
- HCC
- Vascular primaries
- Islet cell carcinoma
- Carcinoid
- Choriocarcinoma
- Renal cell carcinoma
What are common hypoechoic sonographic patterns of metastatic disease? (6)
- Breast
- Lung
- Lymphoma
- Esophagus
- Stomach
- Pancreas
