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DMST ABD 3 > Neoplastic Diseases > Flashcards

Neoplastic Diseases Flashcards

1
Q

What is a neoplasm? 2

A
  1. Tumor, lesion
  2. Abnormal tissue growth
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2
Q

What can a neoplasm look like on ultrasound? 2

A
  1. Diffuse or focal
  2. Distinct mass or ill- defined
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3
Q

Are neoplasms benign or malignant?

A

Both

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4
Q

What are two types of malignant neoplasms?

A
  1. Primary
  2. Metastases
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5
Q

Benign neoplasms are typically asymptomatic or symptomatic?

A

Asymptomatic

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6
Q

Will there be any types of test for benign neoplasms?

A

No altered lab tests

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7
Q

What are some features of benign neoplasms? 5

A
  1. Slow growing
  2. Encapsulated
  3. Well defined
  4. Hypovascular to avascular
  5. DO NOT METASTASIZE
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8
Q

What is the most common type of liver tumor?

A

Hemangiomas

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9
Q

What are the chances of occurrence for hemangiomas for both women and men?

A

Women > Men (5:1)

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10
Q

Are hemangiomas asymptomatic or symptomatic?

A

Asymptomatic

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11
Q

When do hemangiomas increase?

A

During pregnancy or estrogen therapy

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12
Q

What are the typical size of hemangiomas? And what are some sonographic descriptors? 3

A
  1. Typically small (<3cm)
  2. Well defined
  3. Homogenous and hyperechoic
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13
Q

Hemangiomas might include a ________________ _________ ________ with hypoechoic components

A

Heterogenous central area

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14
Q

What is the flow seen with hemangiomas?

A

Slow flow not typically detected by doppler

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15
Q

What is the following up time if someone has a hemangiomas?

A

6 month follow up, document to change

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16
Q

What are focal nodular hyperplasia (FNH)?

A

Hyperplasticity lesion containing all elements of normal liver tissue

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17
Q

What is the occurrence rate of focal nodular hyperplasia between men and women? Why?

A
  1. Women > men
  2. Influenced by hormones
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18
Q

What is FNH known as?

A

Stealth lesion

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19
Q

Are focal Nodular hyperplasia asymptomatic or symptomatic?

A

Asymptomatic

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20
Q

What is the sonographic appearance of FNH? 2

A
  1. Central area of decreased echogenicity (central scar)
  2. Subtle (look for a contour abnormalities/ displaced vessels)
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21
Q

How big are focal nodular hyperplasia (FNH)?

A

Less than 8 cm

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22
Q

What are the doppler flow of focal nodular hyperplasia?

A

Central

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23
Q

When a sulphur colloid is done what might FNH might show?

A

Hot or warm

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24
Q

How common are liver Adenomas?

A

Less common than FNH

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25
Q

What drugs are liver adenomas linked to?

A

Oral contraceptives

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26
Q

What other disease are liver adenomas related to?

A

Type 1 glycogen storage disease (GSD, von gierke’s disease)

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27
Q

Are adenomas asymptomatic or symptomatic?

A

Asymptomatic

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28
Q

Can liver adenomas hemorrhage?

A

Yes they can also infarct which leads to pain

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29
Q

What is the sonographic appearance of liver adenomas? 3

A
  1. Nonspecific (hyperechoic but variable)
  2. Solid, solitary, and well encapsulated
  3. Doppler shows central area of colour
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30
Q

How big are adenomas typically?

A

8-15 cm

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31
Q

What does adenomas show on sulphur colloid scans?

A

Cold

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32
Q

How common are lipomas?

A

Very rare

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33
Q

Lipomas are normally asymptomatic or symptomatic?

A

Asymptomatic

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34
Q

Lipomas sonographic appearance is what? 2

A
  1. Hyperechoic
  2. Very similar to hemangioma
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35
Q

What does CT or MRI do for Lipomas?

A

Contrast enhanced

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36
Q

What are some things we can do to correlate information? 5

A
  1. Contrast enhanced CT or MRI
  2. RBC scintigraphy
  3. Sulfer colloid scans
  4. Micro bubble enhanced sonography
  5. Biopsy
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37
Q

What is the treatment options for hemangiomas?

A

Repeat ultrasound after 3-6 months

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38
Q

What is the treatment options for FNH?

A

Conservative, depending on size

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39
Q

What is the treatment options for adenoma?

A

Surgery recommended

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40
Q

What is the treatment options for lipomas?

A

Conservative

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41
Q

What is the sonographic appearance of benign neoplasms of the spleen? 5

A
  1. Extremely homogenous
  2. More echogenic than the kidney
  3. Isoechoic or slightly more echogenic to the liver
  4. Hilum disrupted by vessels
  5. Inverted comma shape
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42
Q

What kind of disease is a cavernous hemangiomas?

A

Congenital

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43
Q

What is the most common benign neoplasm of spleen?

A

Cavernous hemangioma.

seen far less frequently in the spleen that the liver

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44
Q

Are cavernous hemangiomas symptomatic or asymptomatic?

A

Asymptomatic

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45
Q

What is the sonographic appearance of cavernous hemangiomas?

A

Variable: hyperechoic to complex with cystic degeneration

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46
Q

How conclusive are ultrasounds for cavernous hemangiomas?

A

They are not conclusive, further testing required to differentiate.

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47
Q

How common are hamartoma?

A

Rare

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48
Q

What does Hamartoma’s affect?

A

Lymphoid tissue

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49
Q

What is the sonographic appearance of Hamartoma’s? 4

A
  1. Homogenous
  2. Solid
  3. Echogenic
  4. Not encapsulated
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50
Q

How common are lymphangioma?

A

Rare

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51
Q

What are lymphangiomas?

A

Lymphatic malformation

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52
Q

What is the sonographic appearance of lymphangiomas?

A
  1. Variable appearance
  2. Cystic lymph-angiomyomatosis, multi Lobulated cystic mass
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53
Q

What is an example of true neoplasm?

A

Adenomas

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54
Q

Adenomas are symptomatic or asymptomatic?

A

Asymptomatic

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55
Q

How big are GB adenomas?

A

Less than 10 mm

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56
Q

What is the GB adenomas sonographic appearance? 3

A
  1. Hyperechoic
  2. Homogenous
  3. Hypovascular
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57
Q

What is cholesterolosis?

A

Accumulation of cholesterol in the gallbladder wall

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58
Q

What are different types of cholesterolosis? 2

A
  1. Cholesterosis
  2. Cholesterol polyps
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59
Q

What is cholesterosis also called?

A

Strawberry gallbladder

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60
Q

How will cholesterolosis (strawberry gallbladders) look like?

A

Multiple non- shadowing masses fixed to the GB wall

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61
Q

What kind of form does cholesterol polyps have? Can Cholesterol polyps and adenomas be differentiated with U/S? 2

A
  1. Focal form
  2. Polyps and adenomas cannot be differentiated with U/S
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62
Q

Adenomyomatosis is a exaggeration of what?

A

RA sinuses

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63
Q

Adenomyomatosis is what?

A

Smooth muscle proliferation

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64
Q

What is the Adenomyomatosis sonographic appearance? 3

A
  1. Focal or diffuse
  2. Hyperehoic focus in wall
  3. Comet tail artifact
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65
Q

Adenomyomatosis are most commonly found where in the GB?

A

GB fundus

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66
Q

Adenomyomatosis less commonly affects what?

A

The mid portion creating an hourglass GB

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67
Q

What is a Adenomyomas?

A

Mass like focal area of adenomyomatosis

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68
Q

Adenomas are commonly referred to as what?

A

Polyps

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69
Q

What is the sonographic appearance of benign neoplasms of the pancreas? 4

A
  1. Homogenous
  2. Slightly coarser than liver
  3. ISO/ slightly hypo to liver
  4. Duct may be visible at panc body
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70
Q

Islet cell tumours are benign or malignant ?

A

Both

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71
Q

Islet cell tumors function and non function at what degrees?

A

Functioning (85%) or non- functioning (15%)

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72
Q

What is the most common type of islet cell tumor?

A

Insulinoma

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73
Q

Insulinomas are benign or malignant?

A

Benign

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74
Q

What does the islet cell tumors affect? (which part)

A

Typically the body or tail of the pancreas

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75
Q

What is the sonographic appearance of islet cell tumors? 4

A
  1. Well encapsulated
  2. Solitary
  3. Frequently hypoechoic, though larger tumors may be moderately echogenic
  4. variable size
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76
Q

What is the significance of the two images?

A

Benign neoplasms of the kidneys

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77
Q

What does angiomyolipomas affect? 2

A
  1. Cortex of the kidneys
  2. Fat, muscle, blood vessels
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78
Q

What demographics does angiomyolipoma’s affect?

A

Middle age females

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79
Q

What are some sonographic characteristics of angiomyolipoma’s? 4

A
  1. Hyperechoic, defined
  2. Typically unilateral
  3. Low blood flow
  4. Bilateral, multiple
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80
Q

Is angiomyolipoma’s asymptomatic or symptomatic?

A

Asymptomatic

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81
Q

What can angiomyolipoma’s mimic?

A

Renal cell carcinomas

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82
Q

What is angiomyolipoma’s associated with?

A

Tuberous sclerosis

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83
Q

What does this image demonstrate?

A

Angiomyolipoma

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84
Q

How does the kidney adenoma compare in size to the oncocytoma?

A
  1. Adenoma <3cm
  2. Oncocytoma >3cm
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85
Q

Kidney Adenoma/ oncocytomas are typically asymptomatic or symptomatic?

A

Asymptomatic with possible hematuria, pain

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86
Q

Which demographic does kidney adenoma/ Oncocytoma affect?

A
  1. Male >female
  2. 6th and 7th decade
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87
Q

What does kidney adenoma/ Oncocytomas mimic?

A

Renal cell Cancer

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88
Q

What is the sonographic descriptors of kidney adenoma/ Oncocytoma? 2

A
  1. Well defined
  2. Hypoechoic or isoechoic
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89
Q

What does this image demonstarte?

A

Adenoma/ oncocytoma

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90
Q

Where does adrenal adenomas form?

A

Adrenal cortex

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91
Q

Adrenal Adenomas are hyperfunctioning or nonfunctioning?

A

Both but nonfunctioning most likely

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92
Q

What are some characteristics of adrenal adenomas? 2 (quantity)

A
  1. Commonly unilateral
  2. May be multiple
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93
Q

Hyperfunctioning adrenal adenomas can result in what?2

A

Endocrine abnormalities such as
1. Cushing’s syndrome
2. Conn’s disease

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94
Q

What does this image demonstrate?

A

Adrenal Adenoma

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95
Q

How common are myelolipomas?

A

Rare

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96
Q

Myelolipomas may arise from what?

A

Zona Fasciculata

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97
Q

Are myelolipomas non-functioning or functioning?

A

Non functioning

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98
Q

Which demographics does myelolipomas affect?

A
  1. Male = females
  2. 5 to 6 decade
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99
Q

What are some sonographic descriptors of myelolipomas? 4

A
  1. Hyperechoic
  2. Most <5cm
  3. Blend into perirenal fat
  4. Propagation speed artifact
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100
Q

Pheochromocytomas are what kindof tumour? (Hyper functioning or non functioning, what organ does it affect)

A

Hyperfunctioning tumor of the medulla

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101
Q

What are some signs and symptoms of pheochromocytomas? 5

A
  1. Hypertension
  2. Palpitations
  3. Tachycardia
  4. Excessive sweating
  5. Urinary catecholamines elevated
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102
Q

Which demographics are affected by Pheochromocytomas?

A
  1. 4th to 5th decade
  2. Rt > Lt
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103
Q

What disorders is pheochromocytomas associated with? 2

A

Tuberous sclerosis and MEN syndrome

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104
Q

What are some sonographic descriptors of pheochromocytomas? 7

A
  1. Solid
  2. Unilateral
  3. Encapsulated
  4. Hypoechoic
  5. Homogenous
  6. Heterogenous
  7. > 2cm
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105
Q

What is demonstrated in this image?

A

Pheochromocytoma?

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106
Q

What does desmoid tumors arise from? 2

A
  1. Connective tissue
  2. Usually anterior wall (@ surgical or laparoscopic site)
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107
Q

What are event desmoid tumors associated with?

A

Postpartum

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108
Q

How does desmoid tumors grow?

A

Slow growing but infiltrative locally

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109
Q

Which demographic of individuals are affected by desmoid tumors?

A
  1. females > males
  2. 20 to 40 years of age
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110
Q

What does the desmoid tumor look like sonographically?

A

Hypoechoic, homegenous

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111
Q

What are lipomas consisting of?

A

fat

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112
Q

What are some characteristics of lipomas?4

A
  1. Mobile
  2. Soft on palpation
  3. Compression
  4. Echogenic&raquo_space;» highly echogenic
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113
Q

What does this image demonstrate?

A

Lipomas

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114
Q

Malignant tissue orginates from various types of tissue, what, are some ? 2

A
  1. Primary
  2. Secondary (metastatic)
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115
Q

What are some secondary (metastatic) tissues that develop malignancy?3

A
  1. Blood
  2. Lymphatic s
  3. Direct invasion
116
Q

What are some proven causes of malignant neoplasms?

A

Exposure to carcinogens/ radiation

117
Q

What are some high risk factors for malignant neoplasms? 4

A
  1. Viruses
  2. Familial Tendencies
  3. Environmental
  4. Hormones
118
Q

What are some sonographic signs that would create suspicion of a malignant mass? 6

A
  1. Hypoechoic halo
  2. Hypoechoic solid liver mass
  3. Multiple liver masses
  4. High velocity signals
  5. Hypervascular lesions
  6. Lymphadenopathy
119
Q

What is the most common primary malignant tumor of the liver?

A

Hepatocellular carcinoma (HCC, Hepatoma)

120
Q

Which demographic of individuals are affected by HCC?

A

Males in there 60s

121
Q

What are 3 forms of HCC/ Hepatomas?

A
  1. Focal solitary
  2. Focal multiple
  3. Diffuse
122
Q

What are some risk factors of HCC/ Hepatoma?4

A
  1. Alcohol cirrhosis
  2. Hepatitis B and C
  3. Toxic metabolites
  4. Metabolic disorders
123
Q

What are S/S of HCC? 4

A
  1. RUQ pain
  2. Weight loss
  3. Abdominal swelling
  4. Hepatomegaly
124
Q

What is the normal liver length?

A
  1. Mid clavicular <= 15.5
  2. RT lobe length <17cm
125
Q

What are sonographic descriptors of HCC? 6

A
  1. Variable
  2. Hypoechoic, anechoic halo
  3. Small <5cm
  4. Doppler: high velocity signals
  5. Calcifications uncommon
  6. Portal/ hepatic venous invasion
126
Q

What are lab values affected by HCC?

A
  1. AFP increased in 70% of patients
  2. ALP
  3. AST
  4. ALT
127
Q

What does these images demonstrate?

A

HCC

128
Q

What is the occurrence rate of of Hemangiosarcoma (angiosarcoma)? How aggressive is it?

A

Extremely rare but aggressive

129
Q

What is the demographic of individuals affected by hemangiosarcoma?

A

60-80 years of age

130
Q

What are some characteristics of hemangiosarcoma (angiosarcoma)? 2 (spread, exposure it’s linked to)

A
  1. Metastatic spread rapid
  2. Linked to arsenic/ thorotrast/ polvinyl chloride exposure
131
Q

What are some sonographic appearances of hemangiosarcoma? 2

A
  1. Large mass
  2. Mixed echogenicity
132
Q

What kind of tumour is a Epitheloid Hemangioendothelioma? How common is it?

A
  1. Rare
  2. Malignant vascular tumor
133
Q

What is the sonographic appearance of Epithelioid hemangioendothelioma?what might the hepatic capsule do?

A
  1. Multiple hypoechoic masses
  2. Hepatic capsule overlying the lesion may retract inward
134
Q

What is the most common primary liver tumor in children <5 years of age?

A

Hepatoblastoma

135
Q

What is hepatoblastomas associated with disorder?

A

Beckwith-wiedemann

136
Q

What lab values are affected and how with hepatoblastoma?

A

Serum AFP elevated

137
Q

What is the sonographic appearance of hepatoblastoma?3

A
  1. Single, solid, large
  2. Mixed echogenicity/ poorly defined
  3. Calcium deposits
138
Q

What does this image demonstrate?

A

Hepatoblastoma

139
Q

What are lymphomas?

A

Cancers of lymph tissue

140
Q

What is lymphoma examples? 2

A
  1. Hodgkins
  2. Non- hodgkins
141
Q

Are lymphomas nodal or extra nodal?

A

Both

142
Q

What are some S/S of Hodgkin’s lymphoma? 3

A
  1. Fever
  2. Weight loss
  3. Anemia
143
Q

Which demographic of individuals are affected by hodgkin’s lymphoma? 2

A
  1. Young age group (15-24) and those over 60
  2. Males > females
144
Q

What does Hodgkin’s Lymphoma look like?

A

Painless lymph node enlargement of the clavicle, neck area

145
Q

25% of patients with Hodgkins lymphoma are afflicted with what?

A

Lymphadenopathy

146
Q

What is the survival rate of Hodgkin’s Lymphoma?

A

High

147
Q

Can hodgkin’s lymphoma spread?

A

Yes to other organs

148
Q

What does Non-Hodgkin’s Lymphoma arise from? 2

A
  1. Arise from Lymphoid tissue of organs
  2. 50% paraaortic lymphadenopathy
149
Q

What is the typical demographic that is affected by Non-Hodgkins Lymphoma?

A

> 55-60

150
Q

What are S/S of Non-hodgkins Lymphoma? 3

A
  1. Fever
  2. Weight loss
  3. Night sweats
151
Q

What do we see with Non-hodgkin’s lymphoma? 2

A
  1. Painless neck/ axillary node enlargement
  2. Mets to liver, spleen etc.
152
Q

What is the sonographic appearance of Non-Hodgkin’s Lymphoma? 4

A
  1. Anechoic or hyperechoic, solid, hoogenous masses
  2. Lobulated or scalloped asses
  3. Splenomegaly
  4. Organ and vessel compression/ depression
153
Q

What does this demonstrate?

A

Non-hodgkins Lymphoma

154
Q

What is the sonographic appearance of single malignant nodes? 3

A
  1. Round or oval
  2. Eccentric cortical widening
  3. Narrow or absent hilum
155
Q

What are some characteristics of Hemangiosarcoma? 3 (how common, similarity, Mets?)

A
  1. Rare
  2. Similar appearance to a cavernous hemangioma
  3. Metastasizes to the liver
156
Q

70% of patients of hemangiosarcomas will present with what?

A

Anemia

157
Q

What are gallbladder carcinomas?

A

Adenocarcinomas associated with gallstones

158
Q

Which demographic of individuals are affected by Gallbladder carcinomas?

A
  1. Females > Male
  2. 6th and 7th decade
159
Q

Where does gallbaldder carcinomas spread?

A

to liver and regional lymph nodes common

160
Q

What are S/S of gallbladder carcinomas?2

A
  1. Similar to chronic cholecystits
  2. Jaundice can occur in later stages
161
Q

What is the sonographic appearance of gallbladder carcinomas? 3

A
  1. Polypoid masses with irregular boarders
  2. Focal/ diffuse irregular GB wall thickening
  3. Mass from GB fossa invading adjacent liver
162
Q

What is cholangiocarcioma?

A

Adencarcinoma of the bile ducts

163
Q

How fast does Cholangiocarcinomas grow?

A

Slow

164
Q

What demographics are affected by Cholangiocarcinomas?

A
  1. Male > females
  2. 50 - 60 years
165
Q

What are the risk factors of Cholangiocarcinomas?3

A
  1. Chronic biliary stasis and inflammation
  2. Choledochal cysts
  3. Carolis
166
Q

What is the clinical presentation of cholangiocarcinomas? 3

A
  1. S/S are vague
  2. Jaundice/ pruitis
  3. Elevated serum bilirubin and ALP
167
Q

What are 3 forms of cholangiocarcinoma?

A
  1. Intrahepatic
  2. Distal
  3. Hilar (klatskins)
168
Q

What is the most common tumor of the bile ducts?

A

Klatskins tumor

169
Q

Where does klatskins tumors occur?

A

Confluence of the right and left hepatic duct

170
Q

What is the prognosis of Klatskin tumor?

A

Poor prognosis

171
Q

What is the sonographic appearance of Klatskins tumour? 4

A
  1. CBD normal
  2. Dilated Intrahepatic ducts
  3. Tumor difficult to appreciate
  4. Bulging duct walls
172
Q

What does this demonstrate?

A

Klatskins tumor

173
Q

What is the most common malignancy of the pancreas?

A

Adenocarcinoma

174
Q

What risk factors is bile duct adenomcarcinoma associated with?3

A
  1. Smoking
  2. Alcohol
  3. Diabetes
175
Q

Where in the pancreas is adenocarcinomas located?

A

60-70% located in pancreas head

176
Q

Which demographic of individuals are affected by biliary adenocarcinomas?

A

Older males (60-80 years)

177
Q

What is the prognosis of biliary adenocarcinoma?

A

Poor prognosis

178
Q

What lab value is significant in terms of biliary adenocarcinoma?

A

Lipase

179
Q

What are some S/S of biliary adenocarcinoma? 5

A
  1. weight loss
  2. Painless jaundice
  3. Nausea
  4. Vomiting
  5. Change in stools
180
Q

What are less common S/S of biliary adenocarcinoma? 2

A
  1. Pain radiating to back
  2. Epigastric pain
181
Q

What are some direct signs of biliary adenocarcinomas?3

A
  1. Ill defined solid mass
  2. Hypoechoic, >2cm
  3. Homogenous/ heterogeneous
182
Q

What are indirect signs of adenocarcinomas?

A
  1. Dilated pancreatic duct/ Bile duct dilation (double duct sign)
  2. Dilated GB (courvoiser’s GB/ Palpable mass)
183
Q

What does this image demonstrate?

A

Biliary Adenocarcinomas

184
Q

Which demographic of individuals are affected by cystic neoplasms?

A
  1. Women > men
  2. Middle to older age group
185
Q

What is microcystic (serous cystadenoma)? 2 (Malignancy, location, composition)

A
  1. Benign, more frequent in the pancreatic head
  2. Composed of many small cysts <2cm in size
186
Q

What are some sonographic descriptors of microcystic (serous cystadenoma)?2

A
  1. Well defined
  2. Can appear solid and echogenic due to multiple cystic interfaces
187
Q

What are some characteristics of macrocystic (Mucinous) tumours? 3 (How common, malignancy, location)

A
  1. Uncommon
  2. Malignant
  3. Often in the pancreatic tail
188
Q

What is sonographic appearence of Macrocystic (mucinous) tumors? 3

A
  1. Large, encapsulated
  2. Unilocular or multiocular
  3. composed of larger systic areas (>2cm)
189
Q

What does this image demonstrate?

A

Marcocystic tumors

190
Q

In terms of the primaries of the GI tract what can we assess with ultrasound? 2

A
  1. Normal thickness
  2. Sonographic pattern of thickened gut
191
Q

What is the distended and non distended thickness of the GI tract?

A

D: 3mm
ND: 5mm

192
Q

What are some benign conditions of the GI tract wall?3

A
  1. Long segment involved
  2. Symmetric thickening
  3. Layer preserved
193
Q

What are malignant conditions of wall thickness for the GI tract? 3

A
  1. Short segment
  2. Asymmetric
  3. Wall layer destruction
194
Q

What can we assess in the content of the lumen for GI tract? 2

A
  1. Fluid
  2. Intraluminal masses
195
Q

What things can we assess in the GI tract? 4

A
  1. Content of the lumen
  2. Peristalsis
  3. Compression
  4. Lymphadenopathy and hyperemia
196
Q

What is the S/S of GI tract primaries?4

A
  1. Pain
  2. Anemia
  3. Palpable abdominal mass
  4. Blood in stool
197
Q

What is the most common malignant tumor of the GI tract? What demographic is affected? 2

A
  1. Adenocarcinoma
  2. Males > Females
198
Q

What structures does adenocarcinomas affect in the GI tract? 3

A
  1. Stomach
  2. Small bowel
  3. Colon
199
Q

Which area of the stomach is affected by Adenocarcinoma? 3

A
  1. Prepyloric
  2. Antrum
  3. Lesser curve
200
Q

What area of the small bowel is affected by adenocarcinomas? What increases the incidence rate?

A
  1. Ileum
  2. Increased incidence with crohns disease
201
Q

How common and what areas of the colon are affected by adenocarcinomas?

A
  1. Very common
  2. Polypoid or annular
202
Q

What is the sonographic appearance of adenocarcinomas of the GI tract? 3

A
  1. Large masses, typically hypoechoic
  2. Thick gut wall
  3. Look for nodes or metastases
203
Q

What is the most common tumour of the GT tract in children <10?

A

Lymphoma

204
Q

What are some sonographic appearance of lymphomas?3

A
  1. Hypoechoic, solid nodules
  2. Bowel may appear as target lesion
  3. Mesenteric node involvement
205
Q

What are some primary neoplastic diseases of the urinary tract? 4

A
  1. Renal cell carcinoma
  2. Nephroblastoma
  3. Transitional cell carcinoma
  4. Squamous cell carcinoma
206
Q

What is the most common malignant renal tumor?

A

Renal cell carcinoma

207
Q

What is another name for hypernephroma?

A

Renal cell carcinoma

208
Q

Which demographic is affected by RCC?

A
  1. Males > females
  2. 50-70
209
Q

What conditions is RCC associated with?

A

Von hippel-lindau and tuberous sclerosis

210
Q

What are some clinical presentations of RCC? 5

A
  1. Flank pain
  2. Gross hematuria
  3. Palpable mass
  4. Weight loss
  5. Hypertension
211
Q

RCC can metastasize to all organs but check for what? 3

A
  1. Tumor invasion into IVC and renal veins
  2. Para-aortic nodes
  3. Contralateral kidney
212
Q

What is the sonographic appearance of RCC?4

A
  1. Solid
  2. Variable echogenicity
  3. Possible calcification
  4. Increased flow
213
Q

What does this demonstrate?

A

RCC

214
Q

What is another name for nephroblastoma?

A

Wilm’s tumor

215
Q

What is the most common malignant renal tumor in children?

A

Nephroblastoma

216
Q

Which demographic of individuals are affected for nephroblastoma?

A

3-4

217
Q

What is the clinical presentation of nephroblastoma?5

A
  1. Fever
  2. Hematuria
  3. Hypertension
  4. Palpable mass
  5. Anemia
218
Q

What is the sonographic appearance of nephroblastoma? 6

A
  1. Large, well defined
  2. Solid
  3. Unilateral
  4. Heterogenous/ homogenous
  5. Lymphadenopathy
  6. Metastatic extension
219
Q

What are Transitional cell carcinomas? 2

A
  1. Tumor of the collecting system
  2. Gross of microscopic hematuria
220
Q

What demographic of individuals are affected by TCC?

A

Men > women

221
Q

What is the sonographic appearance of the renal sinus? What are 3 DDX’s?

A
  1. Ill defined, hypoechoic mass
  2. 3 differentials, Blood clots, fungal ball, sloughed papilla
222
Q

What is the image demonstrating?

A

TCC

223
Q

TCC of the bladder look like what?2

A
  1. Focal, non-mobile mass or thickening
  2. Trigone region, lateral and posterior walls
224
Q

What are S/S of TCC of the bladder? 4

A
  1. Painless hematuria
  2. Frequency
  3. Dysuria
  4. Suprapubic pain
225
Q

TCC of the bladder needs what for diagnosis? 2

A
  1. Cystoscopy
  2. Biopsy
226
Q

What is TCC of the ureter? 2

A
  1. Solid mass in ureter
  2. Hydronephrosis above the mass
227
Q

Squamous cell carcinomas occur how often?

A

Rare

228
Q

What demographic is affected by squamous cell carcinomas?

A

Men > women

229
Q

What is squamous cell carcinomas associated with ? 3

A
  1. Chronic UTIs
  2. Stones
  3. Strictures
230
Q

What is the Squamous cell carcinoma?

A

TCC appearance and presentation

231
Q

What is the most commonly diagnosed cancer in men?

A

Prostate adenocarcinoma

232
Q

What is the 2nd leading cause of cancer deaths in men?

A

Prostate adenocarcinoma

233
Q

What demographic is affected with Prostate adenocarcinoma?

A
  1. > 50 years
  2. Men
234
Q

The risk of Prostate adenocarcinoma increases with what? 3

A
  1. Age
  2. Fatty diet
  3. Family history
235
Q

Where does prostate adenocarcinoma develop?

A
  1. Develops in the peripheral zone
  2. Spreads towards capsule
236
Q

What are four steps for evaluation for prostate adenocarcinoma?

A
  1. DRE
  2. PSA
  3. TRUS
  4. Biopsy
237
Q

What are S/S of prostate adenocarcinomas?5

A
  1. Typically asymtomatic
  2. DRE
  3. Bone pain
  4. Weakness
  5. Weight loss
  6. PSA elevated
238
Q

What are sonographic appearnce of prostate adenocarcinoma? 4

A
  1. Small - hypoechoic
  2. Larger - isoechoic, hyperechoic, mix
  3. Loss of smooth contour
  4. Calcifications not common
239
Q

What are treatments of prostate adenocarcinomas?4

A
  1. Watchful waiting
  2. Cryotherapy
  3. Radiation
  4. Radical prostatectomy
240
Q

How common is Adrenal cortical cancer?

A

Rare

241
Q

What demographic is commonly affected by adrenal cortical cancer? 2

A
  1. Hyperfunctional - females
  2. Nonfuncfional - males
242
Q

What are adrenal cortical cancers?

A

Typically adenocarcinomas

243
Q

What are four presentations of adrenal cortical cancers? 4

A
  1. Cushing’s syndrome
  2. Conns disease
  3. Viralization/ Feminiztion
  4. Precocious puberty
244
Q

What is the sonographic appearance of adrenal cortical cancers? 4

A
  1. Well defined, solid mass
  2. Variable echogenicity
  3. Regional and nodal metastases
  4. Possible calcifications
245
Q

Neuroblastoma are benign or malignant?

A

Highly Malignant

246
Q

What demographic of individuals are affected by neuroblastoma?

A

4-5 years

247
Q

Neuroblastoma present with what S/S? 4

A
  1. Palpable mass
  2. Weight loss
  3. Failure to thrive
  4. Highly irritable
248
Q

What are the sonographic appearance of neuroblastomas? 6

A
  1. Solid
  2. Heterogenous
  3. Poorly defined
  4. Calcifications
  5. Renal displacement
  6. Mets
249
Q

What does this represent?

A

Neuroblastoma

250
Q

What are some risk factors of mesothelioma? 2

A
  1. Asbestos exposure
  2. Middle age men
251
Q

What does mesotheliomas look like on U/S ? 3

A
  1. Omental caking
  2. Peritoneal thickening
  3. Ascites
252
Q

What does this demonstrate?

A

Mesothelioma

253
Q

What are the most common sites for metastases? 4

A
  1. Lung
  2. Liver
  3. Bone
  4. Adrenal
254
Q

What is the most common malignant tumor in the liver?

A

METS

255
Q

METS to the liver affect what else? 6

A
  1. GB
  2. Colon
  3. Stomach
  4. Pancreas
  5. Breast
  6. Lung
256
Q

What does METS to the liver look like? 2

A
  1. Multiple solid lesions
  2. Hypo halo (highly suggested of met)
257
Q

What are some symptoms of METS to the liver? 5

A
  1. Hepatomegaly
  2. Jaundice
  3. Pain
  4. Nutritional wasting
  5. Muscle deterioration
258
Q

What does this demonstrate?

A

Mets to the liver

259
Q

What are enzymes affected by METS?

A
  1. LFT abnormal Incrased
  2. ALK PHOS
  3. AST
  4. ALT
260
Q

What is there to know about METs to the spleen? 2 (occurrence, stage)

A
  1. Rare
  2. Later stages of processes
261
Q

Mets to GB not assocaited with what?

A

Gallstones

262
Q

How common is it to see Mets to the pancrease?

A

Uncommon because Mets tend to occur in the very late stages of disease

263
Q

Mets to the pancreas present as what?

A

Small hypoechoic mass

264
Q

How common is METS to the kidneys?

A

Common

265
Q

METS to the kidney’s travel how?

A

From lung, breast and contralateral kidney

266
Q

What is the appearance of Mets to the kidney?

A

Variable appearance

267
Q

Metastatic lymphoma to the kidney look like what sonographically?

A
  1. Nonspecific renal enlargement
  2. Hypoechoic diffusely
  3. Look for displacement of organs or vessels
268
Q

What does this image demonstrate?

A

Metastatic lymphoma

269
Q

How common is Mets to the bladder?

A

Rare

270
Q

How common is GI tract Mets?

A

Rare

271
Q

What is the most common or frequent site of GI neoplasms?

A

Stomach most frequent site followed by small bowel then colon

272
Q

How does GI tract neoplasm look like on U/S ?

A
  1. Large, hypo, well defined masses
  2. Ring down artifact
273
Q

What is the 4th most frequent site of METS?

A

Adrenal

274
Q

How does Mets to the adrenal look? 2

A
  1. May be bilateral
  2. Solid, well defind, hypoehoic
275
Q

How does Mets to the adrenal travel?

A

From lung, breast, and melanoma primaries

276
Q

How does Mets to the retroperitoneum travel?

A

Via lymph, direct extension or blood

277
Q

What is the most common mets to the retroperitoneum?

A

Testicular or pelvic tumor most common

278
Q

Mets to the abdominal wall is typically from what?

A

Malignant melanoma

279
Q

What does Mets to abdominal wall look like sonographically?

A
  1. Hypoechoic mass
  2. Posterior enhancement
280
Q

How does peritoneal carcinomatosis look like? 4

A
  1. Hypoechoic mass
  2. Thickening of peritoneum (omental caking
  3. Ascites
  4. Lymphadenopathy
281
Q

What is peritoneal carcinomatosis?

A

Diffuse metastatic invovlement of the peritoneum

282
Q

Pseudomyxoma peritonei nearly always originates from what?

A

Perforated appendiceal epithelial tumor

283
Q

What are pseudomyxoma peritonei characteristics? 2

A
  1. Rare, variable prognosis
  2. complex, gelatinous ascites
284
Q

What does pseudomyxoma peritonei look like sonographically?

A
  1. Complex ascites
  2. Non mobile bowel loops with posterior and central displacement - starburst appearance
285
Q

What does this demonstrate?

A

Starburst appearance

DMST ABD 3 (11 decks)

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