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GI - Week 2 > Liver neoplasms > Flashcards

Liver neoplasms Flashcards

1
Q

Localized hyperplasia growth around a vascular anomaly or altered blood flow

A

Focal nodular hyperplasia

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2
Q

Multiple Focal nodular hyperplasia is associated with this type of lesion

A

Vascular

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3
Q

This liver neoplasm may have central AVM, may be adjacent to hemangioma or associated with Budd-Chiari
Also associated with Osler-Weber-Rendu syndrome

A

Focal nodular hyperplasia

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4
Q

Pale nodular mass with central stellate scar is seen in this condition

A

Focal nodular hyperplasia

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5
Q

Does Focal nodular hyperplasia have a capsule?

A

No

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6
Q

Is Focal nodular hyperplasia circumscribed?

A

Yes

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7
Q

Are hepatocyte cords normal in Focal nodular hyperplasia?

A

Yes

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8
Q

In this liver neoplasm, surrounding liver is normal, hepatocyte cords are normal, and there are fibrous tracts and scar
Arteries and bile ductules - thick walled arteries, poorly formed elastic laminae

A

Focal nodular hyperplasia

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9
Q

Focal nodular hyperplasia is usually this size

A

< 5 cm

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10
Q

Focal nodular hyperplasia is more common in males or females?

A

Young female

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11
Q

What are the levels of alpha-fetoprotein in Focal nodular hyperplasia?

A

Normal
(this rules out hepatocellular carcinoma)

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12
Q

Radiology of this condition will show a feeder vessel with central scar

A

Focal nodular hyperplasia

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13
Q

Fibrotic liver with ducts and abnormal arterioles are seen on biopsy in this condition

A

Focal nodular hyperplasia

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14
Q

Is Focal nodular hyperplasia at risk of rupture?

A

No, only rarely ruptures

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15
Q

What is the treatment for Focal nodular hyperplasia?

A

No treatment unless symptomatic

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16
Q

Hepatic adenoma most commonly occurs in this patient population

A

Young women - oral contraceptives, estrogen, anabolic steroids

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17
Q

Hepatic adenoma has low risk of malignant transformation, due to activation of this

A

Beta-catenin

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18
Q

Do males or females have the highest risk of malignant transformation of Hepatic adenoma?

A

Male

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19
Q

What are the levels of alpha-fetoprotein in Hepatic adenoma?

A

Normal

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20
Q

This is a well-defined vascular mass of liver parenchyma, often subcapsular
Most >10cm
Intratumoral hemorrhage may produce fibrosis

A

Hepatic adenoma

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21
Q

Are hepatocyte cords normal in Hepatic adenoma?

A

Yes

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22
Q

Morphology of this liver condition will have scattered arteries but no ducts

A

Hepatic adenoma

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23
Q

What is the typical size of Hepatic adenoma?

A

> 10 cm

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24
Q

In Hepatic adenoma, intratumoral hemorrhage may produce this

A

fibrosis

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25
Q

What is the treatment for Hepatic adenoma?

A

Resection
may need transplant if multiple and bilateral

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26
Q

Most common primary malignant tumor of liver in adults
Forms in cirrhotic livers from any etiology

A

Hepatocellular carcinoma

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27
Q

This promotes Hepatocellular carcinoma formation

A

Aspergillus aflatoxin

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28
Q

Aspergillus aflatoxin promotes formation of the liver tumor

A

Hepatocellular carcinoma

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29
Q

Aflatoxin produces a specific mutation on codon 249 of this
Is associated with Hepatocellular carcinoma

A

p53

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30
Q

Perinatal hepatitis B can cause this liver tumor in high-incidence areas (Subsaharan Africa, SE Asia)

A

Hepatocellular carcinoma

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31
Q

What are the levels of alpha-fetoprotein in Hepatocellular carcinoma?

A

Elevated
especially in advanced disease
used to diagnosis and monitor

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32
Q

This compound is elevated in Hepatocellular carcinoma, and used to diagnose and monitor

A

Alpha-fetoprotein

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33
Q

Resection of this liver tumor is difficult due to cirrhotic background
Hematogenous spread to lung common

A

Hepatocellular carcinoma

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34
Q

Why is resection difficult with Hepatocellular carcinoma?

A

Due to cirrhotic background

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35
Q

In Hepatocellular carcinoma, hematogenous spread to this organ is common

A

Lung

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36
Q

Morphology of this condition will show background cirrhosis, +/- dominant nodule, tan to yellow to brown, hemorrhage or necrosis, may invade vessels

A

Hepatocellular carcinoma

37
Q

Morphology of this condition will have abnormal parenchyma architecture, with cords >2 cells thick, and acini or solid sheets

A

Hepatocellular carcinoma

38
Q

This Hepatocellular carcinoma variant has layers of collagen and groups of atypical hepatocytes

A

Fibrolamellar variant

39
Q

Hepatocellular carcinoma fibrolamellar variant is most commonly in this type of patient

A

Young women
No background cirrhosis
(younger ages; good prognosis)

40
Q

Is there background cirrhosis in Hepatocellular carcinoma fibrolamellar variant?

41
Q

Does Hepatocellular carcinoma fibrolamellar variant have a good or poor prognosis?

A

Good
(due to younger age and no background cirrhosis)

42
Q

Hepatocellular carcinoma is typically a mass of this size

43
Q

What are the levels of alpha-fetoprotein in Hepatocellular carcinoma?

A

Elevated
( > 20 ng/ml)

44
Q

This is a malignant tumor of bile duct epithelium
Associated with chronic inflammatory lesions of biliary tree

A

Cholangiocarcinoma

45
Q

Chlonorchis and Opisthorchis infection is a liver fluke associated with this liver tumor

A

Cholangiocarcinoma

46
Q

Cholangiocarcinoma is associated with chronic inflammatory lesions of this

A

Biliary tree

47
Q

Cholangiocarcinoma is common in this location of the world

A

SE Asia
(due to liver flukes)

48
Q

These are the two types of Cholangiocarcinoma

A

Intrahepatic and extrahepatic

49
Q

This type of Cholangiocarcinoma is a large infiltrating tumor in non-cirrhotic liver

A

Intrahepatic

50
Q

This type of Cholangiocarcinoma occurs in right, left, or common hepatic ducts

A

Perihilar tumors
(extrahepatic)

51
Q

This is a Cholangiocarcinoma at the junction of the right and left hepatic ducts

A

Klatskin tumor

52
Q

Klatskin tumor is a Cholangiocarcinoma at the junction of these two ducts

A

Right and left hepatic ducts

53
Q

This type of Cholangiocarcinoma presents early with obstructive jaundice

A

Extrahepatic

54
Q

Extrahepatic Cholangiocarcinoma presents early with this symptom

A

Obstructive jaundice

55
Q

Cholangiocarcinoma patients typically are this age

A

60-70 year olds

56
Q

Weight loss, painless jaundice, clay-color stool, and dark urine are signs of this liver tumor

A

Cholangiocarcinoma

57
Q

Ca 19-9 is a marker for this liver tumor

A

Cholangiocarcinoma

58
Q

What are the levels of alkaline phosphatase in Cholangiocarcinoma?

A

High
(GGT also high)

59
Q

Well-formed glands in dense desmoplastic stroma, and pronounced cytologic atypica are seen morphologically in this liver tumor

A

Cholangiocarcinoma

60
Q

Perineural invasion is almost universal in this liver tumor, in which diagnosis is often made by EUS-directed fine needle aspiration

A

Cholangiocarcinoma

61
Q

What is the main prognostic indicator of Cholangiocarcinoma?

A

Resectability

62
Q

Does extrahepatic or intrahepatic Cholangiocarcinoma have a better prognosis?

A

Extrahepatic

63
Q

This liver tumor spreads with intrahepatic vascular invasion
Regional lymph nodes (hepatic hilum)
Peritoneal carcinomatosis
Hematogenous spread to lungs and bone

A

Cholangiocarcinoma

64
Q

This is also known as vonMeyenberg complex

A

Bile duct hamartoma

65
Q

This is small incidental asymptomatic collections of bile ducts within fibrous stroma
Very common; sporadic
Increased in polycystic kidney/liver disease

A

Bile duct hamartoma

66
Q

Most common liver tumor of early childhood
Involves WNT-signaling pathway (beta-catenin)

A

Hepatoblastoma

67
Q

What are the levels of alpha-fetoprotein in Hepatoblastoma?

68
Q

Fetal type hepatocytes are seen histologically in this condition, which can present with abdominal mass and/or jaundice

A

Hepatoblastoma

69
Q

Hepatoblastoma is associated with these two syndromes

A

Beckwith-Wiedemann syndrome
Familial adenomatous polyposis

70
Q

Beckwith-Wiedemann syndrome and Familial adenomatous polyposis are associated with this liver tumor

A

Hepatoblastoma

71
Q

This is a benign vascular tumor, that is the most common primary liver tumor
Most asymptomatic, may cause vague abdominal pain

A

Hemangioma

72
Q

Does Hemangioma have risk of rupture?

A

Rarely rupture if large
Resect if in danger of rupture

73
Q

What is the typical size of Hemangioma?

74
Q

Morphology of this liver tumor is well-defined, soft, spongy mass, with blood filled channels

A

Hemangioma

75
Q

This malignant tumor of endothelial cells is rare, and is associated with vinyl chloride, Thorotrast, and androgens
Rapidly fatal (within months)

A

Angiosarcoma

76
Q

Morphology of this condition is multicentric, both lobes +/- spleen, infiltrative (often invades PV or HV)

A

Angiosarcoma

77
Q

Is surgery used in Angiosarcoma?

A

No - usually not helpful

78
Q

Morphology of this liver tumor is variegated, solid and hemorrhagic
Atypical pleomorphic endothelial cells

A

Angiosarcoma

79
Q

Is metastatic disease or primary liver malignancy more common?

A

Metastatic is much more common

80
Q

Metastatic liver disease may outgrow blood supply to produce this

A

Central necrosis

81
Q

Metastatic liver disease is most common in these 4 locations

A

Colon, breast, pancreas, lung

82
Q

Disease dominated by kidney cysts and progressive renal failure
A proportion of patients also have multiple liver cysts and/or berry aneurysms

A

Autosomal dominant polycystic kidney disease

83
Q

Similar, but distinct, disease with cystic disease isolated to liver
Results in adult hepatomegaly due to numerous simple cysts

A

Autosomal dominant polycystic liver disease

84
Q

Is Autosomal dominant polycystic kidney disease isolated to the kidney?

A

No - can also produce liver cysts and/or berry aneurysms

85
Q

Is Autosomal dominant polycystic liver disease isolated to the liver?

86
Q

Autosomal dominant polycystic liver and kidney diseases are two disorders that result in this due to numerous simple cysts

A

Adult hepatomegaly

87
Q

Is liver function maintained in Autosomal dominant polycystic liver and kidney diseases?

A

Liver function maintained until late in course

88
Q

What are the levels of alk phos in Autosomal dominant polycystic liver and kidney diseases?

GI - Week 2 (12 decks)

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