Liver Pathology

Question 1

Micronodular cirrhosis is?

Answer 1

commonly caused by chronic alcohol abuse

Question 2

Macronodular cirrhosis is?

Answer 2

caused by chronic viral hepatitis or other infection

Question 3

What is the end stage of Cirrhosis?

Answer 3

Liver cell failure and portal hypertension-

Question 4

Clinical symptoms of Cirrhosis include?

Answer 4

• Nausea
• flatulence
• anorexia, wt. loss,
• light-colored stools
• weakness
• abdominal pain
• varicosities
• spider angiomas

Question 5

80% of patients with preexisting cirrhosis develop what?

Answer 5

hepatocellular carcinoma or HCC

Question 6

Choledocholithiasis

Answer 6

Stone within the duct

Question 7

Passive Hepatic Congestion

Answer 7

Develops secondary to congestive heart failure CHF
Signs of hepatomegaly
Dilation of IVC, SMV, HV, PV, and SV

Question 8

Focal Hepatic Disease

Answer 8

Patients clinical history
Lab values
Sonographic patterns associated with various lesions
Differential diagnosis- cysts, abscess, hematoma, primary tumor, and metastases See Table 9-11
Determine whether the mass is intrahepatic or extrahepatic

Question 9

Congenital Hepatic Cyst

Answer 9

Solitary-rare arises from the developmental defect in the formation of the bile ducts
Tiny to 20 cm. Most often- right lobe

Question 10

Peribiliary Cyst

Answer 10

Tiny, more often seen in patients with the severe liver disease. Seen at the porta hepatis.
Clustered tubular cyst

Question 11

Polycystic Liver Disease

Answer 11

Inherited autosomal dominant, many patients also have polycystic renal disease, small multiple throughout parenchyma

Question 12

3 types of Infectious Disease of the Liver

Answer 12

Intrahepatic
Subhepatic
Subphrenic

• Clinical Symptoms
  Fever
  Elevated WBC count

Question 13

Chronic Granulomatous Disease

Answer 13

Genetic disorder
Phagocytes are unable to kill certain bacteria or fungi
Mostly seen in children, more common in males
- Ultrasound Findings
Poorly marginated hypoechoic mass w/ posterior enhancement
Calcification w/ shadowing may be seen
Aspiration is required to diagnose

Question 14

Amebic Abscess Reach the liver via the?

Answer 14

Portal Vein

Question 15

Amebiasis is contracted by

Answer 15

ingesting the cyst in contaminated water and food

Question 16

Tapeworm that infects humans

Answer 16

Echinococcal Cyst

Enter small intestine and burrow through the mucosa, enter the portal circulation and travel to the liver

A daughter cyst or “cyst within a cyst” may be seen

Question 17

Most common organism causing infection in patients with AIDS

Answer 17

Pneumocystis Carinii

Pneumocystis pneumonia is a common life-threatening infection in patients with HIV
Pneumocystis carinii affects patients undergoing bone marrow and organ transplants, or patients receiving chemo
Ultrasound Findings
Diffuse, tiny, nonshadowing echogenic foci
Or possibly extensive replacement of the liver parenchyma by clumps of calcification

Question 18

Most common benign tumor of the liver

Answer 18

Cavernous Hemangioma

Question 19

Second most common benign liver mass

Answer 19

Focal Nodular Hyperplasia (FNH)

Question 20

Hepatic Adenoma

Answer 20

Rare benign tumor.
Normal or slightly atypical hepatocytes, frequently containing areas of bile stasis and focal hemorrhage or necrosis
More commonly in women and has been related to oral contraceptive usage (hormones)

Question 21

Most common primary malignant neoplasm (that originates in the liver)

Answer 21

Hepatocellular Carcinoma (HCC)

Question 22

Most common form of neoplastic involvement of the liver (spread to the liver)

Answer 22

Metastatic Disease

Question 23

Liver is the ___ most common organ to be injured in the abdomen after spleen and kidney

Answer 23

3rd

Question 24

Diffuse parenchymal changes

Answer 24

Hodgkin’s Lymphoma

Question 25

May appear as a target hypoechoic lesions

Answer 25

Non-Hodgkin’s Lymphoma

Question 26

3 types of ports caval shunts.

Answer 26

Portacaval

Mesocaval

Splenorenal

Question 27

Portacaval

Answer 27

Attaches main portal vein at the confluence to the IVC

Question 28

Mesocaval

Answer 28

Attaches to the mid/dis. SMV to IVC

Question 29

Splenorenal

Answer 29

Attaches the splenic vein to the left renal vein.