Module 2 : Neoplastic Disease Flashcards
typical US appearance of hemangioma of the liver
atypical US appearance of hemangioma
small, usually < 3cm
hyperechoic, homogenous and well defined
no colour flow
heterogenous w/ hypo central area
in which gender is FNH more common
why
women
influenced by hormones
describe FNH
hyperplastic leison made up of normal liver tissue in an abnormal configuration… next most common after hemangioma
can hemangiomas of the liver increase in size w/ preg or estrogen therapy (HRT)
yes
describe a hemangioma of the liver
most common benign tumor in the liver, made of many small blood capillaries
how will a hemangioma appear in a fatty liver
hypoechoic
US appearance of liver lipoma
hyperechoic
very similar to hemangioma
describe a liver adenoma
symptoms?
uncommon benign tumor, next most common after FNH
USUALLY asymp.
general info about benign neoplasms: symptoms lab tests appearance growth vascularity
often asymptomatic no change in lab tests well defined and encapsulated slow growing hypo or avascular
what 2 things are liver adenomas linked to
linked to BCPs and type 1 glycogen storage disease
2 risks associated w/ liver adenomas
hemorrhage or infarct due to large size
what is a neoplasm
can they be diffuse or focal
abnormal tissue growth, cells proliferating at a fast rate
yes
treatment for FNH
conservative, depends on size
what other types of imaging/testing can be used to correlate w/ the finding of a benign liver neoplasm
contrast CT, MRI RBC cell scintigraphy (nuch med) sulphur collloid contrast US biopsy
how will FNH look on a sulpher colloid nuch med scan
why
hot or warm
the kupffer cells will eat up the sulpher colloid
what does type 1 glycogen storage disease cause
another name for it
fatty liver and liver failure due to too much glycogen
Von Gierke’s Disease
follow up for hemangiomas of the liver
re-scan in 6 month and look for changes
describe an adenoma of the GB
the only true neoplasm of the GB, can be pedunculated
Are Desmoid tumors more common in M or W
What age grp
W due to C sections
20-40
best way to differentiate b/w FNH and adenoma
sulphur colloid… hard to differentiate on US
what does exophitic mean
‘sticking out’ of the organ
are most adenoma of the adrenal gland hyper or non functioning
non
describe adenomyomatosis
can it be focal or diffuse
exaggeration of the RA sinuses and proliferation of the smooth muscle wall of the GB which cause cholesterol crystals to become trapped in the walls
yes
if angiomyolipomas are exophitic, why can they be hard to see
blend in w/ renal fat
US appearance of an adenoma of the adrenal gland
solid, round
hypo
treatment for liver lipomas
conservative
Describe a pheochromocytoma of the adrenal gland
Symptoms
Hyperfunctiioning tumour of the medulla
Hypertension
Palpating
Tachycardia
Excessive sweating
are benign neoplasms of the spleen rare or common
rare
What lab tests will be evaluated w/ pheochromocytoma
Urinary catecholamines
what does ‘myelo’ mean
bone marrow or bone forming elements
pheochromocytomas are associated w/ which conditions
Tuberous sclerosis
MEN syndrome (multiple endocrine neoplasia… can be benign or malignant)
are myelolipomas of the adrenal gland more common in one gender
no
what does the term functioning refer to
hormone producing
describe angiomyolipomas (AML) in the kidney
arise from renal cortex
made up of blood vessels, muscle and fat
most common benign neoplastic mass of kidneys
Which tumors are the most common tumor of the abdo wall
Desmoid tumor
statistically, are most focal areas seen in the GB polpys or adenomas
polyps (65%)
How can pheochromocytomas effect the panc
Can displace panc tail anteriorly
is US conclusive in diagnosing a cavernous hemangioma in the spleen
why
no, due to variable appear.
describe a cavernous hemangioma/hemangioma or the spleen
congenital
most common benign neoplasm of the spleen, but not commonly seen
typically, are benign islet cell tumors usually functioning or non functioning
functioning… while most malignant ones are non functioning
angiomyolipomas are most common in which gender and age grp
women
middle age
US appearance of a myelolipoma of the adrenal gland
hyper, can blend in w/ perirenal fat
< 5 cm
propagation speed artifact
US appearance of angiomyolipomas in the kidney
hyper, well defined
unilateral usually
low blood flow
what benign liver neoplasm is rare in the liver but common in the body else-where
lipoma
how does adenomyomatosis effect the size of the GB wall
thickens it… will be >3 mm when distended
how will an adenoma appear on a sulphur colloid scan
cold
US appearance of Desmoid tumor
Hypo and homo
if larger, what malignancy can angiomyolipomas mimic
RCC
describe a hamartoma
US appearance
rare neoplasm composed of lymphoid tissue
homo, solid, echogenic
most common type of islet cell tumor….. is it benign or malignant
where is it typically located in the panc
insulinoma, benign
body or tail
describe tuberous sclerosis
fits and zits - seizures and skin growths
US appearance of FNH
‘stealth leison’
< 8 cm
central scar w/ doppler flow centrally
where in the GB is adenomyomatosis most common
fundus
another name for angiomyolipoma
renal hamartoma
called the hemangioma of the kidney
what is the easiest way to detect FNH when scanning
look for abnorm. contour/displaced vessels
is a hamartoma encapsulated
no
can polyps and adenomas of the GB be differentiated on US
no
when do myelolipomas of the adrenal gland present
5th - 6th decade
US appearance of GB adenoma
hyperechoic and homo
<10mm
avascular
US appearance of cavernous hemangioma of the spleen
variable
can adenomas/oncocytomas mimic RCC
yes, need biopsy to differentiate
symptoms/results of hyperfunctioning adenomas of the adrenal gland
endocrine abnormalities…
Cushings syndrome - increased cortisol
Conns disease - increased aldosterone
describe a myelolipoma of the adrenal gland
symptoms?
rare, non-functioning neoplasm that might arise from the zona fasciculate
can cause pain
what is cholesterolosis/strawberry GB
multiple non shadowing masses fixed to the GB wall
describe adenomas/oncocytomas in the kidney
symptoms?
- benign masses that present in the 6th-7t decade of life
- they are identical, differentiated only by size
possible hematuria, pain
describe islet cell tumors
most common tumor of the panc
can be benign or malignant, functioning or non functioning
angiomyolipomas are associated w/ which condition
how will angiomyolipomas present sonographically in these patients
tuberous sclerosis
bilateral and multiple angiomyolipomas
describe cholesterolosis in the GB
2 types
accumulation of cholestrol in the GB wall
- cholesterolosis (strawberry GB)
- cholesterol polyps
hemangiomas of the liver are more common in which gender
women - 5:1
US appearance of pheochromocytoma
Solid, unilateral
Hypo
Homo or hetero
>2cm
what are cholesterol polyps
focal form of cholesterolosis
describe a lipoma in the liver
symptoms?
very rare
USUALLY asymp.
describe an adenoma of the adrenal gland
arise from adrenal cortex
hyperfunctioning or non-functioning
single and unilateral usually
if adenomyomatosis effects the mid part of the GB how will it look
hour glass
size difference b/w adenomas and oncocytomas
Adeno: < 3 cm
onco: > 3 cm
US appearance of islet cell tumors
solid, solitary usually hypo (larger can be slightly echogenic) variable in size
US appearrance of a liver adenoma
variable- usually hyperechoic
8-15 cm
solid, single
central colour w/ doppler
Describe a lipoma of the abdo wall
US appearance
Made of fat, mobile and soft on palpation, compressible
Slightly hyper to highly echogenic
US appearance of adenomas/oncocytomas
well defined
hypo or iso
in which gender are adenomas/oncocytomas more common
males
which benign tumor is equally common in men and women
myelolipoma
Describe a Desmoid tumor in the abdo wall
Where is it located
Arises from c-tissue (aponeurosis or fascia) often found at a surgical or laparoscopic site
Anterior abdo wall usually
When do pheochromocytomas of the adrenal gland present
Are they more common on the R or L adrenal gland
4th - 5th decade of life
R
Us appearance of adenomyomatosis
hyperechoic foci in the GB wall w/ comet tail artifact
Are Desmoid tumors associated w/ post parting
Yes due to C section
what are adenomyomas in the GB
focal, mass like areas of adenomyomatosis
treatment for liver adenoma
surgery
Describe the growth of Desmoid tumors
Slow, infiltration locally
all masses are asymp. unless otherwise written
encapsulated unless otherwise written
/
describe a lymphangioma of the spleen
US appearance
rare neoplasm cause by lymphatic malformation
variable
can appear as a cystic lymphangiomyomatosis (multi-loculated cyst)
a GB adenoma < than what size is insignificant
<10mm
what are malignant neoplasms
2 different origins
cancerous growths
epithelial
connective tissue
what are 3 routes of spread for metastatic cancer
blood
lymphatics
direct invasion (cancer is in direct contact w/ another organ, facilitating spread)
HCC is specifically associated w/ which metabolic disorder
GSD - glycogen storage disease
another name for HCC
hepatoma
the disruption of the production of which protein produced by the liver may cause ascites?
albumin - controls osmotic balance
malignant neoplasms of which origin are most common
epithelial
risk factors for malignant neoplasms
viruses (HPV, Hep B and C)
family Hx
environment
hormones (HRT)
which lab values will be elevated w/ HCC
ALP AST ALT
and AFP
describe Hepatocellular carcinoma
what are its 3 forms
most common primary tumor of the liver occurring in the 6th decade of life
- focal solitary
- focal multiple
- diffuse infiltration
another name for hemangiosarcoma
angiosarcoma
risk factors for HCC
alcoholic cirrhosis
Hep B and C
toxic metabolites (chronic exposure to chemicals)
metabolic disorders
what % of patients w/ HCC will have increased AFP values
70%
hemangiosarcomas of the liver are associated w/ which risk factors
arsenic
thorotrast (old xray contrast)
PVC exposure (polyvinyl chloride)
is weight loss in older patients always worrisome
yes
list some US signs that would be suspicious of malignancy
hypoechoic halo hypo, solid liver mass multiple liver masses high velocity signs/arterial waveform in a mass hypervascular lymphadenopathy
describe an epitheloid hemangioendothelioma of the liver
US appearance
rare, malignant, vascular tumor
multiple hypo masses
you will see an indentation of the hepatic capsule that is located directly over the lesion
describe lymphoma in general terms
primary malignant neoplasm of the lymphatic syst
can be nodal or extranodal (anywhere in lymph tissue)
is HCC more common in W or M
Men
what does the term ‘blast’ refer to
germ cells
hepatoblastomas are associated w/ which syndrome
Beckwith-Wiedermann syndrome - over growth syndrome
US appearance of Hemangiosarcoma
large
mixed echogenicity
name for malignant neoplasms that have epithelial origin
carcinoma
or more commonly : adenocarcinoma
symptoms of hodgkin’s lymphoma
fever, weight loss, anemia
painless enlargement of lymph nodes in clavicle and neck area
para-AO lymphadenopathy
describe a hepatoblastoma
what age grp does it effect
most common primary liver malignancy in children
often poor prognosis
< 5 yrs
3 benign abnormalities that cant be distinguished from the hyperechoic presentation of HCC
hemangioma
adenoma
lipoma
2 types of lymphoma
hodgkin’s
non-hodgkin’s
describe non-hodgkin’s lymphoma
which age group does it more commonly effect
type of lymphoma arising from lymphoid tissue, specifically T and B cells
typically effects a older age grp (65-74 yrs)
US appearance of hodgkin’s and non-hodgkin’s
- anechoic, hypo, solid, homo masses seen anterior and posterior to the AO/IVC, may be perceived as poor transmission
- lobulated or scalloped
- splenomagaly
- hydro - nodes compressing ureters
- organ and vessel displacement
w/ HCC, is portal or hepatic vein invasion more common
portal
which risk factor of HCC is the most common cause of the disease in the west
alcoholic cirrhosis
symptoms of non-hodgkin’s lymphoma
fever, weight loss, night sweats
painless enlargement of lymph nodes in neck area or axillary
para-AO lymphadenopathy
mets to liver and spleen
hemangiosarcomas of the spleen are associated w/ which condition
anemia (70%)
US appearance of HCC
often hypo w/ an anechoic halo
<5 cm
high velocity signal w/ doppler
portal/hepatic venous invasion
name for malignant neoplasms that have connective tissue origin
sarcoma
what % of people w/ hodgkin’s lymphoma have para-AO lymphadenopathy
25%
what % of people w/ non-hodgkin’s lymphoma have para-AO lymphadenopathy
50%
US appearance of a hemangiosarcoma of the spleen
similar to cavernous hemangioma in the spleen
Another term for GB carcinoma
Is it associated w/ stones
Adenocarcinoma
Yes
does hodgkin’s lymphoma effect M or W more
M
describe a hemangiosarcoma of the spleen
where does it often spread
rare primary tumor of spleen, often there is mets to the liver
Describe a cholangiocarcinoma
What age does it usually occur
a slow growing adenocarcinoma of the bile ducts
50-60 yrs
are conditions w/ painless presentations usually more of less worrisome
more
US appearance of adenocarcinoma of the GB
- Polyp w/ irregular borders or mass
- Thickening of GB wall (focal or diffuse)
- maybe be invading the liver
What does puritus mean
Itchy skin
symptoms of HCC
RUQ pain
weight loss
ascites
hepatomegally (= 15.5cm is norm, 17cm upper limit)
Risk factors for cholangiocarcinoma
- Chronic biliary stasis and inflammation
- Patient Hx of choledochal cyst or caroli’s
proven causes of malignant neoplasms
exposure to carcinogens and radiation
What lab value will be elevated with adenocarcinoma of the panc
Lipase
Which type of cholangiocarcinoma is most common
Hilar / Klatkins
Clinical presentation of adenocarcinoma of the panc
Painless jaundice
Nausea and vomiting
Changes in stool due to obstruction (bile not entering duodenum)
Direct signs of adenocarcinoma of the panc on US
> 2cm
Hypo
variable echoexture
Describe Hilar / Klatkins cholangiocarcinoma
Where do it often occur (location)
Most common cholangiocarcinoma
At the bifurcation of R and L CHD
What’s the prognosis of adenocarcinoma of the panc
Poor
2 types of cystic neoplasms of the panc
- Microscopic (serous cystadenoma)
2. Macroscopic (mucinous cystadenoma)
US appearance of Hilar / Klatkins cholangiocarcinoma
*CBD is norm
*Dilated intrahepatic ducts
solid mass at liver hilum
Bulging of ducts
US appearance of a hepatoblastoma
single, solid, large
mixed echogenicity, poorly defined walls, calcium deposits
Describe an adenocarcinoma of the panc
Risk factors for panc adenocarcinoma
Typically effects panc head
Most common malignancy of the panc
Smoking, alcohol and diabetes
Where is it common for adenocarcinoma of the GB to spread
Lymph nodes and liver
describe a hemangiosarcoma of the liver
what age grp does it typically effect
rare aggressive cancer w/ rapid spread
60-80yrs
what are organ and vessel displacement is specific to hodgkin’s and non-hodgkin’s
floating AO - Ao pushed anteriorly
sandwich - SMA displaced anteriorly
silhouette/mentle sign - enlarged nodes surrounding AO and IVC
In what age group does a cystic neoplasm of the panc usually occur
Middle age to older age group
In what age group does adenocarcinoma of the panc usually occur
60-80 years
US appearance of Macroscopic (mucinous cytadenoma)
Larger cystic areas (>2cm)
Unilocular or multiocular
whats a norm wall thickness of the GI tract when distended and non distended
distended: 3 mm
non distended: 5 mm
what are the advantages of CT and angiography over US
better at assessing vascularity and extent/size
causes of increased peristalsis
obstrution and inflammation
Describe a Microscopic (serous cytadenoma) of the panc
Where does it often occur in the panc
Benign, occurs more often in the panc head
Clinical presentation of cholangiocarcinoma
Which lab values will be increased
Vague/insidious
Jaundice/pruritis
Elevated serum bilirubin and ALP
3 forms of cholangiocarcinom
Intrahepatic
Distal (region of CBD)
Hilar or Klatskins
clinical presentation of GI primary malignant neoplasm
pain
anemia
palpable mass
blood in stool
is an adenocarcinoma of the GI tract occurs in the sm. bowel, which area will likely be effected
increased risk of this w/ which disease
ileum
crohns
can lymphadenopathy and hyperemia be seen in both benign and malignant conditions of the GI
yes
Signs and symptoms of adenocarcinoma of the GB
Similar to chronic cholecystitis (RUQ pain and intolerance to fatty foods)
Jaundice and pruritus in late stages
US pattern of thickened gut
target appearance of pseudo kidney
hypo rim (represents thick gut wall) w/ hyper center (residual lumen)
When does adenocarcinoma of the GB usually present
6-7th decade of life
is adenocarcinoma of the colon common
2 presentations in the colon
yes
polypoid (more often in cecum and AC)
or
annular (descending and sigmoid)
US appearance of adenocarcinoma of the GI
what else should you look for in the abdoment
large, hypo mass
thick gut wall w/ characteristic signs
look for nodes and mets
describe lymphoma of the GI tract
What age group does it effect
can be primary or mets…. if primary will be non-hodgkins
most common GI tumor in children <10
Indirect signs of adenocarcinoma of the panc on US
Dilated panc duct, and bile ducts
Double duct sign
Dilated GB (courvoisier’s GB)
what lab value will be elevated w/ a hepatoblastoma
AFP
will obstructed and inflamed bowel be compressible
no
What is a courvoisier’s GB
Dilated GB that creates palpable mass
what is the most common malignant tumor of GI tract
adenocarcinoma
describe hodgkin’s lymphoma
prognosis?
which age group does it more commonly effect
type of lymphoma that typically effects a younger age grp (15-40 yrs)… spread to other organs but good prognosis
US appearance of lymphoma of the GI tract
hypo, solid nodules
target lesion
involves mesenteric nodes
what is hippel-lindau
inherited disease where people form both benign and malignant tumors in their body
what other areas of the body should you check w/ RCC
IVC for tumor invasion (causes leg edema) renal veins para AO lymph nodes contralateral kidney testes for varicose veins
clinical presentation of nephroblastoma
fever hematuria hypertension palpable mass anemia
how will the GI wall look w/ benign conditions that cause thickening
long segment involved
symmetrical thickening
individual layers are still seen
the term ‘blast’ often refers to what
germ cells….. so these conditions are often more common in children
what other pediatric tumor could a nephroblastoma be confused with and why
neuroblastoma
Describe a Macroscopic (mucinous cytadenoma) of the panc
Uncommon
Malignant, often in a panc tail
all primary malignant tumors of the urinary tract are more common in which gender
men
another name for nephroblastoma
Wilm’s tumor
another name for RCC
hypernephroma
RCC is associated w/ which 2 conditions
tuberous sclerosis
hippel-lindau
clinical presentation of TCC
gross or microscopic hematuria
2 procedure need to diagnose TCC of the bladder
cystoscopy and biopsy
describe a transitional cell carcinoma (TCC) of the kidney
arises from the epithelial lining of the collecting system (eg calyces, renal pelvis, ureters, bladder)
does the annular form of adenocarcinoma in the colon cause obstruction
yes
describe squamous cell carcinoma (bladder)
its associated w/ which conditions
rare, aggressive bladder cancer w/ distal mets
chronic UTIS, stones and strictures
how will the GI wall look w/ malignant conditions that cause thickening
short segment involved
asymmetrical thickening
destruction of layers
nephroblastoma are associated w/ which conditions
Beckwidth wiedemann
US appearance of TCC in the renal sinus
ill defined, hypo mass
clinical presentation and US appearance of squamous cell carcinoma (bladder)
same as TCC
symptoms for TCC of the bladder
painless hematuria
frequency
dyuria
suprapubic pain
US appearance of TCC in the ureters
hydro above the solid mass
describe an adenocarcinoma of the prostate
which zone does it commonly effect
most commonly diagnosed cancer in men
peripheral zone, then spreads towards the capsule
describe a nephroblastoma
what age does it present
most common malignant renal tumor in children
3-4 yrs
US appearance of the Microscopic (serous cytadenoma)
Many small cysts <2 cm
Can appear solid and echogenic due to multiple cysts
US appearance of nephroblastoma
large, well defined, solid, unilateral
variable echotexture
lymphadenopathy and mets
describe a cortical cancer of the adrenal
rare, often an adenoma, in cortical region
can be hyperfunctioning or nonfunctioning
US appearance of adenocarcinoma of the prostate
if sm: hypo
if lrg: variable
prostate losses smooth contour
US appearance of TCC in the bladder
which areas does it commonly effect
non-mobile mass or thickened wall (blood clot would be mobile)
commonly effect the trigone, lateral and posterior walls
signs and symptoms of adenocarcinoma of the prostate
asymp. may have bone pain weakness weight loss PSA elevated
describe a neuroblastoma
what age grp does it effect
highly malignant tumor arising from adrenal medulla
found in children 4-5 yrs
treatment for adenocarcinoma of the prostate
monitor
cryotherapy
radiation (brachytherapy or external beam)
radical prostatectomy (gold standard, risk for nerve damage)
clinical presentation of a neuroblastoma
palpable mass
weight loss
failure to thrive
very irritable
describe RCC
what age grp does it most often effect
an adenocarcinoma that is the most common malignant renal tumor in adults
50-70
3 DDX for TCC in the renal pelvis
blood clot
fungal balls
sloughed papilla (point of pyramid)
US appearance of a neuroblastoma
solid, hetero, poorly defined
calcifications
renal displacement
mets to liver and around great vessels
a mesothelioma of the peritoneum is associated w/ exposure to what materials
what age group and gender does it effect
asbestos
middle aged men
US appearance of cortical cancer of the adrenal
well define, solid mass
variable echogenicity/echotexture
regional and nodal mets
4 clinical presentations of excessive hormone production by the adrenals
cushings syndrome (+ cortisol)
Conns disease (+ aldosterone)
viralization/feminization
precocious puberty
are cortical cancers usually hyperfunctioning or nonfunctioning in males and females
M: non-func.
F: function.
US appearance of mesothelioma of the peritoneum
omental caking/thickening
peritoneal thickeneing
ascites
lymphoma of the peritoneum is associate w/ which condition
AIDS
are malignant neoplasms of the peritoneum rare
yes
US appearance of RCC
variable echogenicity
hypo rim
echotexture tendencies of hyper and non-functioning cortical cancers of the adrenal
hyper: homo
non: hetero
at what age does adenocarcinoma of the prostate usually occur
risk factors
> 50
age, fatty diet, family Hx
Risk factors for GB carcinoma (5 F’s)
Female Fat 40 Fertile Family Hx
clinical presentation of RCC
flank pain gross hematuria palpable mass hypertension weight loss
4 steps for evaluating adenocarcinoma of the prostate
DRE, PSA, TRUS, biopsy
describe lymphoma of the peritoneum
US appearance
non-hodgkin’s type
hypo mass along the peritoneum
most common sites for mets (BALL)
bone
adrenals
liver
lung
are primary or secondary cancers the most common malignant tumor(s) of the liver
secondary
what lab values will be increase w/ liver mets
LFTs:
Alk phos
AST
ALT
Us appearance of GI mets
large, well defined, hypo mass w/ ring down
what is peritoneal carcinomatosis
US appearance
diffuse metastatic spread to peritoneum
omental caking/thickening
hypo nodules or masses
ascites
mesenteric thickening or lymphadenopathy
which cancers usually mets to the adrenals
lung
breast
melanoma
is mets to the GB usually associated w/ gallstones
no (where as primary cancer of the GB are)
US appearance of metastatic lymphoma to the kidney
- non-specific renal enlargement and diffusely hypo kidney
- look for vessel/organ displacement due to enlarged nodes
appearance of other types of kidney mets are variable
which organ is the 4th most common site of mets
adrenal
know for registry
typical US appearance of panc mets
small hypo mass
is adrenal mets usually bilateral
yes
is lymphadenopathy often seen w/ mets
yes
Acronym for all malignant and benign neoplasms that are more common in women
FAD & HCG
F - FNH
A - AML & adenoma
D - Desmoid
H - Hemangioma
C - Cystic neoplasms of the panc
G - GB carcinoma
signs and symp. of liver mets
hepatomegally
jaundice
pain
anorexia/nutritional wasting and muscle deterioration
what is pseudomyxoma peritonei
gelatinous ascites that almost always originates from perforated appendiceal epithelial tumor
US appearance of pseudomyxoma peritonei
complex ascites
non mobile bowel loops pushed centrally and posteriorly, creating the ‘starburst appearance’
mets to which organs/areas of the body are rare
spleen
panc
GI tract
bladder
is mets to the kidney common
from which organs?
yes
lung, breast, other kidney
mets to the abdo wall typically occurs from which primaries
Us appearance
melanoma
hypo mass w/ posterior enhancement (dont confuse w/ a cyst)
does liver mets usually produce symptoms
no
Acronym for all malignant and benign neoplasms that are more common in men
MAAC HALL
M - Mesothelioma
A - Adenoma of the GI
A - Adenoma of the panc
C - Cholangiocarcinoma
H - HCC
A - Adenoma/oncocytoma of the kidney
L - Lymphoma (Hodgkins)
L - Lymphoma of the GI
All primary malignancies of the peritoneum (mesotheiloma and lyphoma of GI)
and ALL primary malignancies of the urinary tract (not included here)
what is needed to determine the origin of mets tumors
biopsy
Acronym for all malignant and benign neoplasms that can have a variable US appearance
H[AL]L MARC
H - hemangioma of the spleen/hemangiosarcoma of the spleen
AL - abdo wall lipoma (varying degrees of echogenic)
L - lymphangioma of the spleen
M - mets to the liver
A - adenoma of the liver (often hyper but varies)
R - RCC (vairable ecogenicity)
C - cortical cancer
prognosis for pseudomyxoma peritonei
variable
most common site for mets to the GI to occur
stomach, then Sm bowel, the colon
suggestice US appearance for liver mets
multiple lesions
hypoechoic halo
mets to the retroperitoneum typically occurs from which primaries
testicular
pelvic tumors
