Liver Path 3- Nelson Flashcards
Define hemangioma
Lesions consists of discrete red-blue hemorrhagic nodules composed of dilated (cavernous) endothelial lined blood filed channels
Most common neoplasm of the liver?
Hemangioma
Define simple cyst
single, or small cluster of cysts
Usually discovered with imaging study or at autopsy
Not associated with PKD
Does not communicate with biliary system
Define polycystic liver disease
Multiple cysts often associated with polycystic kidney disease
Cysts do not communicate with biliary system
Define choledochal cyst
Congenital dilation of the common bile duct
What are some complications of a choledochal cyst?
Biliary obstruction
Stones
Bile duct carcinoma
Define Caroli’s disease
Refers to several congenital disorders resulting in intrahepatic biliary dilatations which communicate with the biliary tree
What is congenital hepatic fibrosis?
Non-cirrhotic fibrotic liver disease of children, with an autosomal recessive inheritance
Focal Nodular Hyperplasia?
Well-demarcated lesion composed of a proliferation of ALL liver parenchymal elements: central veins, hepatocytes, portal triads
Describe a characteristic of focal nodular hyperplasia that may be seen on imaging
Central fibrous scar may be seen with imaging studing
Nodular Regenerative Hyperplasia
Diffuse NON-FIBROSISING nodular hyperplasia of the liver
easier to see grossly than microscopically
Key complication of nodular regenerative hyperplasia
Portal hypertension
Define hepatocellular adenoma
Well-circumscribed benign neoplasm composed of well-differentiated hepatocytes
No portal triads or central veins
Characteristic population that gets hepatocellular adenoma?
Young reproductive aged women
Associated with prolonged use of oral contraceptives containing high estrogen content
Describe gross appearance of bile duct hamartoma
Appear as single or commonly multiple small white nodules
Mimics metastatic carcinoma
Describe gross appearance of bile duct adenoma
Solitary
Benign proliferation of bile ducts
Describe CT imaging findings of malignancies metastatic to liver
Show multiple hepatic nodules
How does patient population of HCC differ between USA and China?
USA patients > 60 years
China is younger patients due to high carrier rate of HBV and HCV
Most important risk factors of HCC?
Chronic liver disease!
- viral hepatits infections
- Exposure to toxins
Gross appearance of HCC?
Solitary large mass or multiple nodules
Typically soft and hemorrhagic
What procedure can be sued to screen for HCC?
Elevated serum alpha-fetoprotein may be present
What is fibrolamellar variant of HCC?
Polygonal oncocytic tumor cells in nests and cords separated by lamellar fibrous stroma
Young adults
Without cirrhosis or chronic viral hepatitis
Define cholangiocarcinomas
Carcinoma arising from intrahepatic or extrahepatic bile ducts
Virtually always adenocarcinomas
Risk factor for intrahepatic cholangiocarcinoma
Patients with viral hepatitis B and C and NAFLD
What entity would need to be excluded before one could make a diagnosis of intrahepatic choloangiocarcinoma?
Adenocarcinoma metastatic to the liver would need to be excluded
