liver lesions

Question 1

Liver lesions

Answer 1

321
Primary- Benign (Hemangioma, Focal nodular hyperplasia, Adenoma), Malignant (Hepatocellular Carcinoma, Cholangiocarcinoma), Metstatic

Question 2

history hints

Answer 2

Oral contraceptives- Hepatic adenoma
Extrahepatic malignancy- metastatic disease
Underlying liver disease- Heptocellular carcinoma
History of primary sclerosing cholangitis (PSC)- cholangiocarcinoma CCA

Question 3

tumors that are cirrhotic vs non

Answer 3

non- usually benign

Cirrhotic- usually carcinoma

Question 4

Hemancioma

Answer 4

most common liver lesion, found in a non cirrhotic liver
Congenital vascular malformation
found in 30s to 50s (incidental)
1-20 cm
Multiples in 30%
no malignancy potential

Question 5

Focal nodulat hyperplasia

Answer 5

central stellate star

found in non cirrhotic liver
A reaction to intra hepatic anomolous artery leading to hyper perfusion- hyperperfused area enlarges until it out grows its blood supply

Women between ages of 20 and 50

majority <5 cm
Can be multiple, no malignancy

Question 6

Hepatic adenoma

Answer 6

found in non cirrhotic liver, benign proliferation of hepatocytes, majority in women of child bearing age, associated with contraceptves, asyptomatic, multiple adenomas also seen in (Glycogen storage disease and DM

Risk of hemrrhage and malignant transformation, discontinuation and avoid pregnancy, surgical resection

Question 7

HCC

Answer 7

follows viral hep B and C

C in the us
also NAFLD

tumor takes the blood from the hepatic artery

(Hep B does not have to go thru cirrhosis to be cancerous)

Question 8

Alpha feto protein

Answer 8

produced by fetal liver and placenta, elevated in 60% of HCC pts, values greater than 200 ng/ml in conjunction with liver lesion on imaging is consistent with HCC

Question 9

Prevention of HCC

Answer 9

hep b vaccination, treat hepatitis, coffee liver enzymes, cirrhosis

Question 10

Met carcinoma

Answer 10

usually multiple lesions in the liver