Liver Part 3 Flashcards
4 types of malignant hepatic neoplasms
Hepatocellular carcinoma (HCC)
Fibrolamellar carcinoma
Hemangiosarcoma
Hapatic epitheliod hemangioendothelioma
One of the most common malignant tumours
Hepatoma / HCC
Hepatoma/ HCC more common in waht gender
Males
Causes of HCC/hepatoma (4)
Alcoholic cirrhosis
Viral hep B&C
Fatty liver
Toxins
Clinical presentation of HCC often delayed until tumor reaches an
Advanced stage
Symptoms of HCC (3)
RUQ pain
Weight loss
Abdominal swelling with ascites
HCC has invasion of portal vein in ___- ___ % of cases
30-60%
Budd chiari symptom is when
HCC invades hepatic venous system
Sonographic appearance of HCC
Hypoechoic, complex or hyper
Smaller nodules
May have hypoechoic halo
Necrosis and fibrosis may be seen over time
Fibrolamellar carcinoma is subtype of
HCC
Distinguishing character of fibromellar carcinoma
Central echogenic scar
Hemangiosarcomas are (4)
Rare
Seen in older adults
Associated with specific carcinogens
Mis echogenicity mass
Hepatic ecpitheliod (4)
Rare
Occurs in adults
Soft tissues, lungs and liver
Multiple hypoechoic nodules
What does neoplasm mean
Tumour
Common primary tumors resulting in liver metastases are from
GB Colon Stomach Panc Breast Lung
Blood borne routes from metastic liver
Hepatic A, portal vein
Lymphatic spread of metastic liver disease
Stomach,
Panc
Ovary
Uterus
Tumor cells from the GI tract are drain through
Portal system to the liver
Mets are
Single or multifocal liver lesions with identical sonographic morphology
Mets wit hhypoechoic halo strongly signs _______
Malignancy
Common echogenic patterns of metastic disease (7)
Gi tract HCC vascular primaries Islet cell carcinoma Carcinoid Choriocarcinoma Renal cell carcinoma
commmon Hypoechoic patterns of metastatic disease (6)
Breast Lung Lymphoma Esophagus Stomach Pancreas
Echogenic metastatic disease tends to arise from ____ or ______
GI tract or HCC
Echogenic metastatic disease is generally _____vascular
Hypervascular
Echogenic metastatic disease may mimic ________ on sonography
Hemangioma
Hypoechoic metastatic disease generally is ______vascular
Hypovascular
Bulls eye or target is typically seen with
Lung cancer
Bulls eye or target appearance is
Hypoechoic peripheral halo
Nonspecific and common appearance
5 calcified metastases
Mucinous adenocarcinoma Osteogenic sarcoma Chondrosarcoma Tetratocarcinoma Neuroblastoma
Shadowing in the liver is most often due to
Calcifications
Air
Stones
Fat containing legions
Clean shadow is causesd by
Calcifications
Dirty shadow caused by
Air
What is the most common cause of a calcified liver tumour
Metastases
3 cystic metastases (mets)
Necrosis- sarcomas
Cystadenocarcinoma of ovary and panc
Mucinous carcinoma of colon
Are cystic metastases distinguishable from simple cysts
Yes
Character traits of cystic metastases (4)
Mural nodules
Thick walls
Internal septations
Extensive necrosis
Infiltrative mets are seen with (3)
Breast
Lung
Malignant melanoma
Infiltrative metastatic disease diffuse disorganization of
Parenchyma
Infiltrative metastatic disease is easy or hard to seen on US
Hard
Infiltrative metastatic disease can be confused with
Cirrhosis or fatty liver
