Liver Lesions Flashcards

1
Q

Which lesions in the liver are benign?

A
  • Haemangioma
  • Focal nodular hyperplasia
  • Adenoma
  • Liver cysts
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2
Q

Which lesions, found in the liver, may be malignant?

A
  • Primary liver cancers e.g. hepatocellular carcinoma
  • Metastases
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3
Q

What is the most common liver tumour?

A

Haemangioma

This is benign

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4
Q

Which gender is affected more often by haemangioma?

A

Females

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5
Q

How may a haemangioma be diagnosed and what is suitable treatment?

A
  • Ultrasound
  • CT
  • MRI

No treatment needed

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6
Q

What is focal nodular hyperplasia?

A

Formation of benign nodes in the liver

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7
Q

Which symptoms are associated with focal nodular hyperplasia?

A

It is usually an asymptomatic condition

However, minimal pain may be present

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8
Q

Focal nodular hyperplasia is a malignant condition

True or false?

A

False

It is benign

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9
Q

How is focal nodular hyperplasia diagnosed?

A
  • Ultrasound
  • CT
  • MRI
  • Fine needle aspiration (for cells)

This is a benign condition

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10
Q

What is the treatment for focal nodular hyperplasia?

A

No treatment

It is a benign condition

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11
Q

Hepatic adenoma is a benign condition, but where may pain be felt?

A

RUQ

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12
Q

Hepatic adenoma is associated with what?

A

Contraceptive hormones and anabolic steroids

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13
Q

In patients with hepatic adenoma, how does the treatment vary between males and females?

A

Males - always surgically removed regardless of size - males have a higher risk of the tumour becoming malignant

Females - if it is <5cm it is not removed, if it is >5cm or increasing in size it is surgically removed

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14
Q

What causes hyatid cysts?

A

Tapeworms

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15
Q

How is a diagnosis of an hyatid cyst made?

A

History

Appearance

Serological testing - presence of anti-Echinococcus antibodies (antibodies against the worm)

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16
Q

Which medication is used for patients with hyatid cysts?

A

Albendazole

(used for many parasitic infections)

17
Q

As well as albendazole, what other treatment options are available for patients with hyatid cysts?

A
  • Surgery
  • Percutaneous drainage
18
Q

What are the three types of polycystic liver disease?

A
  1. Von Meyenburg complexes (VMC)
  2. Polycystic liver disease
  3. Autosomal dominant polycystic kidney disease
19
Q

Which type of polycystic liver disease causes a potentially massive hepatic enlargement?

A

Autosomal dominant polycystic kidney disease

20
Q

Which clinical findings would be present for a liver abscess?

A
  • High fever
  • Leukocytosis (high WCC)
  • Abdominal pain
  • Complex liver lesion
21
Q

A dental procedure may lead to which benign liver condition?

A

Liver abscess

22
Q

How can a liver abscess be managed and treated?

A

Broad spectrum antibiotics initially

Aspiration or drainage

ECG

Operation

4 week antibiotic therapy with repeat imaging to assess progress

23
Q

What is the most common primary liver cancer?

A

Hepatocellular carcinoma

24
Q

What are the risk factors for hepatocellular carcinoma?

A

Cirrhosis from any cause e.g.

  • Hep B/C
  • Alcohol
  • Aflatoxin
  • Others
25
What are the signs of hepatocellular carcinoma?
Weight loss RUQ pain Acute liver failure Cirrhosis Hard RUQ mass Liver bruit (rare)
26
In order to diagnose hepatocellular carcinoma which is the modality of choice and why?
Imaging Small lesions may not elevate AFP
27
In terms of diagnosing hepatocellular carcinoma, AFP elevation is not enough alone, what else is required?
Imaging modality technique US, CT, MRI
28
What is the best treatment available for hepatocellular carcinoma?
Liver transplantation Only done when tumour \<5cm or less than 3 tumours \<3cm each
29
When would resection be a viable treatment option for hepatocellular carcinoma?
When there are small tumours and preserve liver function Reccurence rate is high
30
When would local ablation be used for patients with hepatocellular carcinoma?
When patients cannot undergo surgery This is merely palliative and not curative
31
What is the most common site for blood borne metastases?
Liver
32
Besides hepatocellular carinoma, what other types of malignant lesions can affect the liver?
* Fibrolamellar carcinoma - young age, no relation to cirrhosis * Hepatoblastoma