Liver Pathology Flashcards
Micronodular cirrhosis is?
commonly caused by chronic alcohol abuse
Macronodular cirrhosis is?
caused by chronic viral hepatitis or other infection
What is the end stage of Cirrhosis?
Liver cell failure and portal hypertension-
Clinical symptoms of Cirrhosis include?
- Nausea
- flatulence
- anorexia, wt. loss,
- light-colored stools
- weakness
- abdominal pain
- varicosities
- spider angiomas
80% of patients with preexisting cirrhosis develop what?
hepatocellular carcinoma or HCC
Choledocholithiasis
Stone within the duct
Passive Hepatic Congestion
Develops secondary to congestive heart failure CHF
Signs of hepatomegaly
Dilation of IVC, SMV, HV, PV, and SV
Focal Hepatic Disease
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
Congenital Hepatic Cyst
Solitary-rare arises from the developmental defect in the formation of the bile ducts
Tiny to 20 cm. Most often- right lobe
Peribiliary Cyst
Tiny, more often seen in patients with the severe liver disease. Seen at the porta hepatis.
Clustered tubular cyst
Polycystic Liver Disease
Inherited autosomal dominant, many patients also have polycystic renal disease, small multiple throughout parenchyma
3 types of Infectious Disease of the Liver
Intrahepatic
Subhepatic
Subphrenic
- Clinical Symptoms
Fever
Elevated WBC count
Chronic Granulomatous Disease
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
Amebic Abscess Reach the liver via the?
Portal Vein
Amebiasis is contracted by
ingesting the cyst in contaminated water and food
Tapeworm that infects humans
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
Most common organism causing infection in patients with AIDS
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
Most common benign tumor of the liver
Cavernous Hemangioma
Second most common benign liver mass
Focal Nodular Hyperplasia (FNH)
Hepatic Adenoma
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)
Most common primary malignant neoplasm (that originates in the liver)
Hepatocellular Carcinoma (HCC)
Most common form of neoplastic involvement of the liver (spread to the liver)
Metastatic Disease
Liver is the ___ most common organ to be injured in the abdomen after spleen and kidney
3rd
Diffuse parenchymal changes
Hodgkin’s Lymphoma
May appear as a target hypoechoic lesions
Non-Hodgkin’s Lymphoma
3 types of ports caval shunts.
Portacaval
Mesocaval
Splenorenal
Portacaval
Attaches main portal vein at the confluence to the IVC
Mesocaval
Attaches to the mid/dis. SMV to IVC
Splenorenal
Attaches the splenic vein to the left renal vein.
