Liver Path 3- Nelson

Question 1

Define hemangioma

Answer 1

Lesions consists of discrete red-blue hemorrhagic nodules composed of dilated (cavernous) endothelial lined blood filed channels

Question 2

Most common neoplasm of the liver?

Answer 2

Hemangioma

Question 3

Define simple cyst

Answer 3

single, or small cluster of cysts

Usually discovered with imaging study or at autopsy

Not associated with PKD
Does not communicate with biliary system

Question 4

Define polycystic liver disease

Answer 4

Multiple cysts often associated with polycystic kidney disease

Cysts do not communicate with biliary system

Question 5

Define choledochal cyst

Answer 5

Congenital dilation of the common bile duct

Question 6

What are some complications of a choledochal cyst?

Answer 6

Biliary obstruction
Stones
Bile duct carcinoma

Question 7

Define Caroli’s disease

Answer 7

Refers to several congenital disorders resulting in intrahepatic biliary dilatations which communicate with the biliary tree

Question 8

What is congenital hepatic fibrosis?

Answer 8

Non-cirrhotic fibrotic liver disease of children, with an autosomal recessive inheritance

Question 9

Focal Nodular Hyperplasia?

Answer 9

Well-demarcated lesion composed of a proliferation of ALL liver parenchymal elements: central veins, hepatocytes, portal triads

Question 10

Describe a characteristic of focal nodular hyperplasia that may be seen on imaging

Answer 10

Central fibrous scar may be seen with imaging studing

Question 11

Nodular Regenerative Hyperplasia

Answer 11

Diffuse NON-FIBROSISING nodular hyperplasia of the liver

easier to see grossly than microscopically

Question 12

Key complication of nodular regenerative hyperplasia

Answer 12

Portal hypertension

Question 13

Define hepatocellular adenoma

Answer 13

Well-circumscribed benign neoplasm composed of well-differentiated hepatocytes

No portal triads or central veins

Question 14

Characteristic population that gets hepatocellular adenoma?

Answer 14

Young reproductive aged women

Associated with prolonged use of oral contraceptives containing high estrogen content

Question 15

Describe gross appearance of bile duct hamartoma

Answer 15

Appear as single or commonly multiple small white nodules

Mimics metastatic carcinoma

Question 16

Describe gross appearance of bile duct adenoma

Answer 16

Solitary

Benign proliferation of bile ducts

Question 17

Describe CT imaging findings of malignancies metastatic to liver

Answer 17

Show multiple hepatic nodules

Question 18

How does patient population of HCC differ between USA and China?

Answer 18

USA patients > 60 years

China is younger patients due to high carrier rate of HBV and HCV

Question 19

Most important risk factors of HCC?

Answer 19

Chronic liver disease!

• viral hepatits infections
• Exposure to toxins

Question 20

Gross appearance of HCC?

Answer 20

Solitary large mass or multiple nodules

Typically soft and hemorrhagic

Question 21

What procedure can be sued to screen for HCC?

Answer 21

Elevated serum alpha-fetoprotein may be present

Question 22

What is fibrolamellar variant of HCC?

Answer 22

Polygonal oncocytic tumor cells in nests and cords separated by lamellar fibrous stroma

Young adults
Without cirrhosis or chronic viral hepatitis

Question 23

Define cholangiocarcinomas

Answer 23

Carcinoma arising from intrahepatic or extrahepatic bile ducts

Virtually always adenocarcinomas

Question 24

Risk factor for intrahepatic cholangiocarcinoma

Answer 24

Patients with viral hepatitis B and C and NAFLD

Question 25

What entity would need to be excluded before one could make a diagnosis of intrahepatic choloangiocarcinoma?

Answer 25

Adenocarcinoma metastatic to the liver would need to be excluded