Limjoco Flashcards
Due to heterogenous microcirculation from obliteration of small portal veins and arterialization
Nodular regenerative hyperplasia
Associated with many different diseases (rheumatoid arthritis, lupus, systemic sclerosis, PAN, polycythemia Vera, chronic Granulomatous diseases, cystinosis, mastocytosis, amyloidosis)
Nodular regenerative hyperplasia
Nodular regenerative hyperplasia will have _______ ALP and GGT
Elevated
Nodular regenerative hyperplasia ____ fibrosis, unlike cirrhosis
Lacks
Benign tumor of hepatocytes. Seen in young women of reproductive age who have taken oral contraceptives and men on androgen therapy
Hepatocellular adenoma
Usually solitary. Pale, yellow-tan. Only has sheets and cords of normal liver cells
Hepatocellular adenoma
Well circumscribed, unencapsulated pale tumor
Hepatocellular adenoma
Only see proliferation of hepatocytes and thin vessels. No biliary channels or portal tracts
Hepatocellular adenoma
Mistaken for HCC
Hepatocelluar adenoma
Subcapsular tumor can rupture, especially during pregnancy. Rarely transforms into carcinomas (except during glycogen storage disease)
Hepatocellular adenoma
Most common benign liver tumor.
Cavernous hemangioma
Discrete, Subcapsular red-blue soft nodule
Cavernous hemangioma
Asymptomatic. Incidentally found in middle aged female. Can rupture
Cavernous hemangioma
Diagnose cavernous hemangioma by
Imaging
May present as Kasabach-Merritt syndrome (microangiopathic anemia w/ consumption coagulopathy)
Cavernous hemangioma
Rarely bleeds. Can cause erythrocytosis from erythropoietin secretion
Cavernous hemangioma
Malignant liver tumor arising from hepatocytes. Most common primary malignant liver tumor in adults. Usually Arise in setting of cirrhosis
HCC
Associated with Hep B in SE Asia, Africa, and China
HCC
Main cause of increase in incidence in the 1990s in the USA was Hep B and Hep C
HCC
Associated with alcoholic and non-alcoholic cirrhosis, NASH, hemochromatosis, primary biliary cirrhosis, AIH, aflatoxin
HCC
Obesity related fatty liver disease and NASH is increasing, which will cause an increase of this in coming decades
HCC
HCC has ____ AFP
Elevated
_________ is increased in HCC, chronic Hep C, and cirrhosis
AFP
Paler than surrounding parenchyma. May be green. Propensity for vascular invasion > mets.
HCC
Develops about 10 yrs after cirrhosis
HCC
Seen in young adults (20-40 yrs). Seen in the absence of underlying liver disease or cirrhosis
Fibrolamellar variant of HCC
Same clinical manifestations as usual HCC, but has better prognosis
Fibrolamellar variant of HCC
Transformation of entire liver into multiple 1-2 mm nodules w/o fibrous septa between nodules
Nodular regenerative hyperplasia
