Liver Nodules and Tumors Flashcards
What are the main types of benign hepatic nodules/tumors?
Nodular hyperplasias:
- focal nodular hyperplasia
- nodular regenerative hyperplasia
Cavernous hemangioma
Hepatocellular adenoma:
- HNF1-α
- inflammatory
- β-catenin
What is the most common benign neoplasm of the liver?
-cavernous hemangioma
What is focal nodular hyperplasia?
benign nodular hyperplasia of the liver
- typcially single, well demarcated lesion w/ central scar
- “maplike pattern”
What is nodular regenerative hyperplasia?
benign nodular hyperplasia of the liver
- typically multiple nodules
- appears like cirrhosis, but lacks fibrous septa
What is cavernous hemangioma of the liver?
benign neoplasm of the liver
- asymptomatic
- has life threatening risk of hemorrhage
What are the subtypes of the hepatic adenomas?
HNF1-α:
- fatty change with no atypia
- mostly female
- minimal risk of transformation
β-catenin activated:
- associated with oral contraceptives and anaboic steroids
- males and females
- high risk of transformation
Inflammatory:
- most common hepatic adenoma (40-50%)
- associated with metabolic syndrome
- mimics focal nodular hyperplasia
What are the main types of malignant tumors of the liver?
Primary hepatic tumors:
- hepatoblastoma
- hepatocellular carcinoma
- colangiocarcinoma
Metastasis:
- colon
- breast
- lung
- pancreas
What is the most common liver tumor of early childhood?
-hepatoblastoma
What are the types of malignant liver tumors?
- hepatocellular carcinoma
- cholangiocarcinoma
- angiosarcome
- lymphoma
- metastasis
What is the most common primary liver tumor?
-hepatocellular carcinoma
What is the most common liver tumor of any origin?
-tumor metastasis to the liver is significanlty more common that primary liver tumors
How does hepatoblastoma present?
- typicaly asymptomatic
- jaudice and pruritis if symptomatic
- abdominal swelling typcial presenting sign
- typically not detected until metastasis has already occured
What is the most common cause of HCC?
-HBV and HCV
What feature is most associated with development of HCC?
What are common causes?
80% of HCC arises in the setting of cirrhosis:
- HBV/HCV
- alcoholic liver disease
- NASH
- hemochromatosis
- Wilson disease
- α-1 anittrypsin deficiency
- hepatic autoimmune disease (PBC/PSC)
With no cirrhosis:
- aflatoxin (Aspergillus toxin)
- transformation of adenomas
- HBV
What cause of HCC is odd in that it can cause HCC both w/ and w/o cirrhosis?
-HBV