Liver tumours and biliary tract Flashcards
What are the risk factors for hepatocellular carcinomas?
cirrhosis Male Obesity Alcohol High prevalence of hepatitis
What signs and symptoms point to hepatocellular carcinoma?
Worsening liver function
Weight loss
Ultrasound showing any soft nodules
Blood tests - raised alpha feto-protein serum
How do nodules present in hepatocellular carcinoma?
Soft
Expansile
Green (bile)
Often multifocal if developed from cirrhosis
How is hepatocellular carcinoma diagnosed histologically?
Cells may look normal
May produce bile
Immunohistochemistry to confirm
What is the prognosis for hepatocellular carcinoma?
Very poor
What is the treatment for hepatocellular carcinoma?
Surgery
Transplant
Chemotherapy
Embolisation
What staging is used for hepatobiliary carcinoma?
TNM
Which cancers commonly metastasis to the liver?
Few large nodules = Large bowl Multinodual/infiltrative = Lung Pancreas Breast Stomach Melenoma
What are the 4 most common types of gallstones?
Mixed stones
Cholesterol stones - yellow
Pigment stones - black, in haemolytic anaemia
Calcium stones
How do gallstones form?
Precipitation of componants of bile
What are the complication of gallstones?
Cholecystitis - Inflammation of gallbladder
Mucocele - swelling with mucus in the bladder
Carcinoma of the gallbladder
Obstruction of biliary system = biliary colic/jaundice
Cholangitis/liver abscesses = infection of static bile
Gallstone ileus
Pancreatitis
What is acute cholecystitis caused by?
Duct blocked by stone
How does acute cholecystitis present?
Large
Swollen
Congested
Ulcerated
What are the complications of acute cholecystitis?
Empyema - collection of pus in a cavity in the body
Rupture
What is chronic cholecystitis caused by?
Usually gallstones
