Neoplastic Diseases Flashcards
1
Q
What is a neoplasm? What kind of growth is it?
A
- Tumor, lesion
- Abnormal tissue growth
2
Q
What can we describe a neoplasm on ultrasound? 2
A
- Diffuse or focal
- Distinct mass or ill- defined
3
Q
Are neoplasms benign or malignant?
A
Both
4
Q
What are two types of malignant neoplasms?
A
- Primary
- Metastases
5
Q
Benign neoplasms are typically asymptomatic or symptomatic?
A
Asymptomatic
6
Q
Will there be any types of test for benign neoplasms?
A
No altered lab tests
7
Q
What are some features of benign neoplasms? 5
A
- Slow growing
- Encapsulated
- Well defined
- Hypovascular to avascular
- DO NOT METASTASIZE
8
Q
What is the most common type of liver tumor?
A
Hemangiomas
9
Q
What are the chances of occurrence for hemangiomas for both women and men?
A
Women > Men (5:1)
10
Q
Are hemangiomas asymptomatic or symptomatic?
A
Asymptomatic
11
Q
When do hemangiomas increase for women?
A
During pregnancy or estrogen therapy
12
Q
What are the typical size of hemangiomas? And what are some sonographic descriptors? 3
A
- Typically small (<3cm)
- Well defined
- Homogenous and hyperechoic
13
Q
Hemangiomas might include a ________________ _________ ________ with hypoechoic components
A
Heterogenous central area
14
Q
What is the flow seen with hemangiomas?
A
Slow flow not typically detected by doppler
15
Q
What is the following up time if someone has a hemangiomas?
A
6 month follow up, document to change
16
Q
What are focal nodular hyperplasia (FNH)?
A
Hyperplasticity lesion containing all elements of normal liver tissue
17
Q
What is the occurrence rate of focal nodular hyperplasia between men and women? Why?
A
- Women > men
- Influenced by hormones
18
Q
What is FNH known as?
A
Stealth lesion
19
Q
Are focal Nodular hyperplasia asymptomatic or symptomatic?
A
Asymptomatic
20
Q
What is the sonographic appearance of FNH? 2
A
- Central area of decreased echogenicity (central scar)
- Subtle (look for a contour abnormalities/ displaced vessels)
21
Q
How big are focal nodular hyperplasia (FNH)?
A
Less than 8 cm
22
Q
What are the doppler flow of focal nodular hyperplasia?
A
Central
23
Q
When a sulphur colloid is done what might FNH might show?
A
Hot or warm
24
Q
How common are liver Adenomas?
A
Less common than FNH
25
What drugs are liver adenomas linked to?
Oral contraceptives
26
What other disease are liver adenomas related to?
Type 1 glycogen storage disease (GSD, von gierke’s disease)
27
Are adenomas asymptomatic or symptomatic?
Asymptomatic
28
Can liver adenomas hemorrhage?
Yes they can also infarct which leads to pain
29
What is the sonographic appearance of liver adenomas? 3
1. Nonspecific (hyperechoic but variable)
2. Solid, solitary, and well encapsulated
3. Doppler shows central area of colour
30
How big are adenomas typically?
8-15 cm
31
What does adenomas show on sulphur colloid scans?
Cold
32
How common are lipomas?
Very rare
33
Lipomas are normally asymptomatic or symptomatic?
Asymptomatic
34
Lipomas sonographic appearance is what? 2
1. Hyperechoic
2. Very similar to hemangioma
35
What does CT or MRI do for Lipomas?
Contrast enhanced
36
What are some things we can do to correlate information? 5
1. Contrast enhanced CT or MRI
2. RBC scintigraphy
3. Sulfer colloid scans
4. Micro bubble enhanced sonography
5. Biopsy
37
What is the treatment options for hemangiomas?
Repeat ultrasound after 3-6 months
38
What is the treatment options for FNH?
Conservative, depending on size
39
What is the treatment options for adenoma?
Surgery recommended
40
What is the treatment options for lipomas?
Conservative
41
What is the sonographic appearance of the spleen? 5
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
42
What kind of disease is a cavernous hemangiomas?
Congenital
43
What is the most common benign neoplasm of spleen?
Cavernous hemangioma.
*seen far less frequently in the spleen that the liver*
44
Are cavernous hemangiomas symptomatic or asymptomatic?
Asymptomatic
45
What is the sonographic appearance of cavernous hemangiomas?
Variable: hyperechoic to complex with cystic degeneration
46
How conclusive are ultrasounds for cavernous hemangiomas?
They are not conclusive, further testing required to differentiate.
47
How common are hamartoma?
Rare
48
What does Hamartoma’s affect?
Lymphoid tissue
49
What is the sonographic appearance of Hamartoma’s? 4
1. Homogenous
2. Solid
3. Echogenic
4. Not encapsulated
50
How common are lymphangioma?
Rare
51
What are lymphangiomas?
Lymphatic malformation
52
What is the sonographic appearance of lymphangiomas? 2
1. Variable appearance
2. Cystic lymph-angiomyomatosis, multi Lobulated cystic mass
53
What is an example of true neoplasm?
Adenomas
54
Adenomas are symptomatic or asymptomatic?
Asymptomatic
55
How big are GB adenomas?
Less than 10 mm
56
What is the GB adenomas sonographic appearance? 3
1. Hyperechoic
2. Homogenous
3. Hypovascular
57
What is cholesterolosis?
Accumulation of cholesterol in the gallbladder wall
58
What are different types of cholesterolosis? 2
1. Cholesterosis
2. Cholesterol polyps
59
What is cholesterosis also called?
Strawberry gallbladder
60
How will cholesterolosis (strawberry gallbladders) look like?
Multiple non- shadowing masses fixed to the GB wall
61
What kind of form does cholesterol polyps have? Can Cholesterol polyps and adenomas be differentiated with U/S? 2
1. Focal form
2. Polyps and adenomas cannot be differentiated with U/S
62
Adenomyomatosis is a exaggeration of what?
RA sinuses
63
Adenomyomatosis is what? (Proliferation of what layer of the GB)
Smooth muscle proliferation
64
What is the Adenomyomatosis sonographic appearance? 3
1. Focal or diffuse
2. Hyperehoic focus in wall
3. **Comet tail artifact**
65
Adenomyomatosis are most commonly found where in the GB?
GB fundus
66
Adenomyomatosis less commonly affects what?
The mid portion creating an hourglass GB
67
What is a Adenomyomas?
Mass like focal area of adenomyomatosis
68
Adenomas in the gallbladder are commonly referred to as what?
Polyps
69
What is the sonographic appearance of the pancreas? 4 (comparison to the liver, duct location, echo texture)
1. Homogenous
2. Slightly coarser than liver
3. ISO/ slightly hypo to liver
4. Duct may be visible at panc body
70
Islet cell tumours are benign or malignant ?
Both
71
Islet cell tumors function and non function at what degrees?
Functioning (85%) or non- functioning (15%)
72
What is the most common type of islet cell tumor?
Insulinoma
73
Insulinomas are benign or malignant?
Benign
74
What does the islet cell tumors affect? (which part of the pancreas)
Typically the body or tail of the pancreas
75
What is the sonographic appearance of islet cell tumors? 4
1. Well encapsulated
2. Solitary
3. Frequently hypoechoic, though larger tumors may be moderately echogenic
4. variable size
76
What is the significance of the two images?
Benign neoplasms of the kidneys
77
What does angiomyolipomas affect? 2
1. Cortex of the kidneys
2. Fat, muscle, blood vessels
78
What demographics does angiomyolipoma's affect?
Middle age females
79
What are some sonographic characteristics of angiomyolipoma's? 4
1. Hyperechoic, defined
2. Typically unilateral
3. Low blood flow
4. Bilateral, multiple
80
Is angiomyolipoma's asymptomatic or symptomatic?
Asymptomatic
81
What can angiomyolipoma's mimic?
Renal cell carcinomas
82
What condition is angiomyolipoma's associated with?
Tuberous sclerosis
83
What does this image demonstrate?
Angiomyolipoma
84
How does the kidney adenoma compare in size to the oncocytoma?
1. Adenoma <3cm
2. Oncocytoma >3cm
85
Kidney Adenoma/ oncocytomas are typically asymptomatic or symptomatic? What is another s/s seen with this?
Asymptomatic with possible hematuria, pain
86
Which demographic does kidney adenoma/ Oncocytoma affect?
1. Male >female
2. 6th and 7th decade
87
What does kidney adenoma/ Oncocytomas mimic?
Renal cell Cancer
88
What is the sonographic descriptors of kidney adenoma/ Oncocytoma? 2
1. Well defined
2. Hypoechoic or isoechoic
89
What does this image demonstarte?
Adenoma/ oncocytoma
90
Where does adrenal adenomas form?
Adrenal cortex
91
Adrenal Adenomas are hyperfunctioning or nonfunctioning?
Both but nonfunctioning most likely
92
What are some characteristics of adrenal adenomas? 2 (quantity + side(s))
1. Commonly unilateral
2. May be multiple
93
Hyperfunctioning adrenal adenomas can result in what?2
Endocrine abnormalities such as
1. Cushing's syndrome
2. Conn's disease
94
What does this image demonstrate?
Adrenal Adenoma
95
How common are myelolipomas?
Rare
96
Myelolipomas may arise from what? (Adrenal layer)
Zona Fasciculata
97
Are myelolipomas non-functioning or functioning?
Non functioning
98
Which demographics does myelolipomas affect?
1. Male = females
2. 5 to 6 decade
99
What are some sonographic descriptors of myelolipomas? 4
1. Hyperechoic
2. Most <5cm
3. Blend into perirenal fat
4. **Propagation speed artifact**
100
Pheochromocytomas are what kindof tumour? (Hyper functioning or non functioning, what organ does it affect)
Hyperfunctioning tumor of the medulla
101
What are some signs and symptoms of pheochromocytomas? 5
1. Hypertension
2. Palpitations
3. Tachycardia
4. Excessive sweating
5. Urinary catecholamines elevated
102
Which demographics are affected by Pheochromocytomas? (Age and side)
1. 4th to 5th decade
2. Rt > Lt
103
What disorders is pheochromocytomas associated with? 2
Tuberous sclerosis and MEN syndrome
104
What are some sonographic descriptors of pheochromocytomas? 7
1. Solid
2. Unilateral
3. Encapsulated
4. Hypoechoic
5. Homogenous
6. Heterogenous
7. >2cm
105
What is demonstrated in this image?
Pheochromocytoma?
106
What does desmoid tumors arise from? Where does it usually affect?
1. Connective tissue
2. Usually anterior wall (@ surgical or laparoscopic site)
107
What events are desmoid tumors associated with? (think period after surgery)
Postpartum
108
How does desmoid tumors grow?
Slow growing but infiltrative locally
109
Which demographic of individuals are affected by desmoid tumors?
1. females > males
2. 20 to 40 years of age
110
What does the desmoid tumor look like sonographically? 2
Hypoechoic, homegenous
111
What are lipomas consisting of?
fat
112
What are some characteristics of lipomas?4
1. Mobile
2. Soft on palpation
3. Compression
4. Echogenic >>>> highly echogenic
113
What does this image demonstrate?
Lipomas
114
Malignant tissue orginates from various types of tissue, what, are some ? 2
1. Primary
2. Secondary (metastatic)
115
What are some secondary (metastatic) tissues that develop malignancy?3 (route)
1. Blood
2. Lymphatic s
3. Direct invasion
116
What are some proven causes of malignant neoplasms?
Exposure to carcinogens/ radiation
117
What are some high risk factors for malignant neoplasms? 4
1. Viruses
2. Familial Tendencies
3. Environmental
4. Hormones
118
What are some sonographic signs that would create suspicion of a malignant mass? 6 (in the liver)
1. Hypoechoic halo
2. Hypoechoic solid liver mass
3. Multiple liver masses
4. High velocity signals
5. Hypervascular lesions
6. Lymphadenopathy
119
What is the most common primary malignant tumor of the liver?
Hepatocellular carcinoma (HCC, Hepatoma)
120
Which demographic of individuals are affected by HCC?
Males in there 60s
121
What are 3 forms of HCC/ Hepatomas?
1. Focal solitary
2. Focal multiple
3. Diffuse
122
What are some risk factors of HCC/ Hepatoma?4
1. Alcohol cirrhosis
2. Hepatitis B and C
3. Toxic metabolites
4. Metabolic disorders
123
What are S/S of HCC? 4
1. RUQ pain
2. Weight loss
3. Abdominal swelling
4. Hepatomegaly
124
What is the normal liver length?
1. Mid clavicular <= 15.5
2. RT lobe length <17cm
125
What are sonographic descriptors of HCC? 6
1. Variable
2. Hypoechoic, anechoic halo
3. Small <5cm
4. Doppler: high velocity signals
5. Calcifications uncommon
6. Portal/ hepatic venous invasion
126
What are lab values affected by HCC? 4
1. **AFP increased in 70% of patients**
2. ALP
3. AST
4. ALT
127
What does these images demonstrate?
HCC
128
What is the occurrence rate of of Hemangiosarcoma (angiosarcoma)? How aggressive is it?
Extremely rare but aggressive
129
What is the demographic of individuals affected by hemangiosarcoma?
60-80 years of age
130
What are some characteristics of hemangiosarcoma (angiosarcoma)? 2 (spread, exposure it’s linked to)
1. Metastatic spread rapid
2. Linked to arsenic/ thorotrast/ polvinyl chloride exposure
131
What are some sonographic appearances of hemangiosarcoma? 2
1. Large mass
2. Mixed echogenicity
132
What kind of tumour is a Epitheloid Hemangioendothelioma? How common is it?
1. Rare
2. Malignant vascular tumor
133
What is the sonographic appearance of Epithelioid hemangioendothelioma?what might the hepatic capsule do?
1. Multiple hypoechoic masses
2. Hepatic capsule overlying the lesion may retract inward
134
What is the most common primary liver tumor in children <5 years of age?
Hepatoblastoma
135
What is hepatoblastomas associated with disorder? (Disease)
Beckwith-wiedemann
136
What lab values are affected and how with hepatoblastoma?
Serum AFP elevated
137
What is the sonographic appearance of hepatoblastoma?3
1. Single, solid, large
2. Mixed echogenicity/ poorly defined
3. Calcium deposits
138
What does this image demonstrate? (ped)
Hepatoblastoma
139
What are lymphomas?
Cancers of lymph tissue
140
What is lymphoma examples? 2
1. Hodgkins
2. Non- hodgkins
141
Are lymphomas nodal or extra nodal?
Both
142
What are some S/S of Hodgkin's lymphoma? 3
1. Fever
2. Weight loss
3. Anemia
143
Which demographic of individuals are affected by hodgkin's lymphoma? 2
1. Young age group (15-24) and those over 60
2. Males > females
144
What does Hodgkin's Lymphoma look like?
Painless lymph node enlargement of the clavicle, neck area
145
25% of patients with Hodgkins lymphoma are afflicted with what?
Lymphadenopathy
146
What is the survival rate of Hodgkin's Lymphoma?
High
147
Can hodgkin's lymphoma spread?
Yes to other organs
148
What does Non-Hodgkin's Lymphoma arise from? 2
1. Arise from Lymphoid tissue of organs
2. **50% paraaortic lymphadenopathy**
149
What is the typical demographic that is affected by Non-Hodgkins Lymphoma?
>55-60
150
What are S/S of Non-hodgkins Lymphoma? 3
1. Fever
2. Weight loss
3. Night sweats
151
What do we see with Non-hodgkin's lymphoma? 2 (Areas affected)
1. Painless neck/ axillary node enlargement
2. Mets to liver, spleen etc.
152
What is the sonographic appearance of Non-Hodgkin's Lymphoma? 4
1. Anechoic or hyperechoic, solid, hoogenous masses
2. Lobulated or scalloped asses
3. Splenomegaly
4. Organ and vessel compression/ depression
153
What does this demonstrate?
Non-hodgkins Lymphoma
154
What is the sonographic appearance of single malignant nodes? 3
1. Round or oval
2. Eccentric cortical widening
3. Narrow or absent hilum
155
What are some characteristics of Hemangiosarcoma? 3 (how common, similarity, Mets?)
1. Rare
2. Similar appearance to a cavernous hemangioma
3. Metastasizes to the liver
156
70% of patients of hemangiosarcomas will present with what? (S/S)
Anemia
157
What are gallbladder carcinomas?
Adenocarcinomas associated with gallstones
158
Which demographic of individuals are affected by Gallbladder carcinomas?
1. Females > Male
2. 6th and 7th decade
159
Where does gallbaldder carcinomas spread?
to liver and regional lymph nodes common
160
What are S/S of gallbladder carcinomas?2 (What it looks like and what can happen at later stages)
1. Similar to chronic cholecystits
2. Jaundice can occur in later stages
161
What is the sonographic appearance of gallbladder carcinomas? 3
1. Polypoid masses with irregular boarders
2. Focal/ diffuse irregular GB wall thickening
3. Mass from GB fossa invading adjacent liver
162
What is cholangiocarcioma?
Adencarcinoma of the bile ducts
163
How fast does Cholangiocarcinomas grow?
Slow
164
What demographics are affected by Cholangiocarcinomas?
1. Male > females
2. 50 - 60 years
165
What are the risk factors of Cholangiocarcinomas?3 (diseases)
1. Chronic biliary stasis and inflammation
2. Choledochal cysts
3. Carolis
166
What is the clinical presentation of cholangiocarcinomas? 3 (s/s)
1. S/S are vague
2. Jaundice/ pruitis
3. Elevated serum bilirubin and ALP
167
What are 3 forms of cholangiocarcinoma?
1. Intrahepatic
2. Distal
3. Hilar (klatskins)
168
What is the most common tumor of the bile ducts?
Klatskins tumor
169
Where does klatskins tumors occur?
Confluence of the right and left hepatic duct
170
What is the prognosis of Klatskin tumor?
Poor prognosis
171
What is the sonographic appearance of Klatskins tumour? 4
1. **CBD normal**
2. **Dilated Intrahepatic ducts**
3. Tumor difficult to appreciate
4. Bulging duct walls
172
What does this demonstrate?
Klatskins tumor
173
What is the most common malignancy of the pancreas?
Adenocarcinoma
174
What risk factors is bile duct adenomcarcinoma associated with?3
1. Smoking
2. Alcohol
3. Diabetes
175
Where in the pancreas is adenocarcinomas located?
60-70% located in pancreas head
176
Which demographic of individuals are affected by biliary adenocarcinomas?
Older males (60-80 years)
177
What is the prognosis of biliary adenocarcinoma?
Poor prognosis
178
What lab value is significant in terms of biliary adenocarcinoma?
Lipase
179
What are some S/S of biliary adenocarcinoma? 5
1. weight loss
2. Painless jaundice
3. Nausea
4. Vomiting
5. Change in stools
180
What are less common S/S of biliary adenocarcinoma? 2
1. Pain radiating to back
2. Epigastric pain
181
What does biliary adenocarcinomas look like sonographically? 3
1. Ill defined solid mass
2. Hypoechoic, >2cm
3. Homogenous/ heterogeneous
182
What are indirect signs of adenocarcinomas? 2 (pancreas)
1. Dilated pancreatic duct/ Bile duct dilation (double duct sign)
2. Dilated GB (courvoiser's GB/ Palpable mass)
183
What does this image demonstrate?
Biliary Adenocarcinomas
184
Which demographic of individuals are affected by cystic neoplasms?
1. Women > men
2. Middle to older age group
185
What is microcystic (serous cystadenoma)? 2 (Malignancy, location in the pancreas, composition)
1. Benign, more frequent in the pancreatic head
2. Composed of many small cysts <2cm in size
186
What are some sonographic descriptors of microcystic (serous cystadenoma of the pancreas)?2
1. Well defined
2. Can appear solid and echogenic due to multiple cystic interfaces
187
What are some characteristics of macrocystic (Mucinous) tumours? 3 (How common, malignancy, location in pancreas)
1. Uncommon
2. Malignant
3. Often in the pancreatic tail
188
What is sonographic appearence of Macrocystic (mucinous) tumors? 3
1. Large, encapsulated
2. Unilocular or multiocular
3. composed of larger systic areas (>2cm)
189
What does this image demonstrate?
Marcocystic tumors
190
In terms of the primaries of the GI tract what can we assess with ultrasound? 2
1. Normal thickness
2. Sonographic pattern of thickened gut
191
What is the distended and non distended thickness of the GI tract?
D: 3mm
ND: 5mm
192
What are some benign conditions of the GI tract wall?3 (What are some signs that make use lean more towards benign conditions, what segment is involved, what is thickening like, and what happens to the layers)
1. Long segment involved
2. Symmetric thickening
3. Layer preserved
193
What are malignant conditions of wall thickness for the GI tract? 3 (Segment involved, thickening, layer)
1. Short segment affected
2. Asymmetric
3. Wall layer destruction
194
What can we assess in the content of the lumen for GI tract? 2
1. Fluid
2. Intraluminal masses
195
What things can we assess in the GI tract? 4
1. Content of the lumen
2. Peristalsis
3. Compression
4. Lymphadenopathy and hyperemia
196
What is the S/S of GI tract primaries?4
1. Pain
2. Anemia
3. Palpable abdominal mass
4. Blood in stool
197
What is the most common malignant tumor of the GI tract? What demographic is affected? 2
1. Adenocarcinoma
2. Males > Females
198
What structures (organs) does adenocarcinomas affect in the GI tract? 3
1. Stomach
2. Small bowel
3. Colon
199
Which area of the stomach is affected by Adenocarcinoma? 3
1. Prepyloric
2. Antrum
3. Lesser curve
200
What area of the small bowel is affected by adenocarcinomas? What increases the incidence rate?
1. Ileum
2. Increased incidence with crohns disease
201
How common and what areas of the colon are affected by adenocarcinomas?
1. Very common
2. Polypoid or annular
202
What is the sonographic appearance of adenocarcinomas of the GI tract? 3
1. Large masses, typically hypoechoic
2. Thick gut wall
3. Look for nodes or metastases
203
What is the most common tumour of the GT tract in children <10?
Lymphoma
204
What are some sonographic appearance of lymphomas?3 (in bowel)
1. Hypoechoic, solid nodules
2. Bowel may appear as target lesion
3. Mesenteric node involvement
205
What are some primary neoplastic diseases of the urinary tract? 4
1. Renal cell carcinoma
2. Nephroblastoma
3. Transitional cell carcinoma
4. Squamous cell carcinoma
206
What is the most common malignant renal tumor?
Renal cell carcinoma
207
What is another name for hypernephroma?
Renal cell carcinoma
208
Which demographic is affected by RCC?
1. Males > females
2. 50-70
209
What conditions is RCC associated with?
Von hippel-lindau and tuberous sclerosis
210
What are some clinical presentations of RCC? 5 (s/s)
1. Flank pain
2. Gross hematuria
3. Palpable mass
4. Weight loss
5. Hypertension
211
RCC can metastasize to all organs but check for what? 3
1. Tumor invasion into IVC and renal veins
2. Para-aortic nodes
3. Contralateral kidney
212
What is the sonographic appearance of RCC?4
1. Solid
2. Variable echogenicity
3. Possible calcification
4. Increased flow
213
What does this demonstrate?
RCC
214
What is another name for nephroblastoma?
Wilm's tumor
215
What is the most common malignant renal tumor in children?
Nephroblastoma
216
Which demographic of individuals are affected for nephroblastoma?
3-4
217
What is the clinical presentation of nephroblastoma?5 (s/s)
1. Fever
2. Hematuria
3. Hypertension
4. Palpable mass
5. Anemia
218
What is the sonographic appearance of nephroblastoma? (4) Which side is typically affected? Is there metastatic extension?
1. Large, well defined
2. Solid
3. Unilateral
4. Heterogenous/ homogenous
5. Lymphadenopathy
6. Metastatic extension
219
What are Transitional cell carcinomas? What is the most common symptom seen with it?
1. Tumor of the collecting system
2. Gross of microscopic hematuria
220
What demographic of individuals are affected by TCC?
Men > women
221
What is the sonographic appearance of the renal sinus tumors? What are 3 DDX’s?
1. Ill defined, hypoechoic mass
2. 3 differentials, Blood clots, fungal ball, sloughed papilla
222
What is the image demonstrating?
TCC
223
TCC of the bladder look like what? What is affected?
1. Focal, non-mobile mass or thickening
2. Trigone region, lateral and posterior walls
224
What are S/S of TCC of the bladder? 4
1. Painless hematuria
2. Frequency
3. Dysuria
4. Suprapubic pain
225
TCC of the bladder needs what for diagnosis? 2
1. Cystoscopy
2. Biopsy
226
What is TCC of the ureter? What is seen above the mass?
1. Solid mass in ureter
2. Hydronephrosis above the mass
227
Squamous cell carcinomas occur how often?
Rare
228
What demographic is affected by squamous cell carcinomas?
Men > women
229
What conditions is squamous cell carcinomas associated with ? 3
1. Chronic UTIs
2. Stones
3. Strictures
230
How does Squamous cell carcinoma look and present like?
TCC appearance and presentation
231
What is the most commonly diagnosed cancer in men?
Prostate adenocarcinoma
232
What is the 2nd leading cause of cancer deaths in men?
Prostate adenocarcinoma
233
What demographic is affected with Prostate adenocarcinoma?
1. >50 years
2. Men
234
The risk of Prostate adenocarcinoma increases with what? 3
1. Age
2. Fatty diet
3. Family history
235
Where does prostate adenocarcinoma develop? Where does it spread?
1. Develops in the peripheral zone
2. Spreads towards capsule
236
What are four steps for evaluation for prostate adenocarcinoma?
1. DRE
2. PSA
3. TRUS
4. Biopsy
237
What are S/S of prostate adenocarcinomas? 6
1. Typically asymtomatic
2. DRE
3. Bone pain
4. Weakness
5. Weight loss
6. PSA elevated
238
What are sonographic appearnce of prostate adenocarcinoma? 4 (small, large, contour, Calc)
1. Small - hypoechoic
2. Larger - isoechoic, hyperechoic, mix
3. Loss of smooth contour
4. Calcifications not common
239
What are treatments of prostate adenocarcinomas?4
1. Watchful waiting
2. Cryotherapy
3. Radiation
4. Radical prostatectomy
240
How common is Adrenal cortical cancer?
Rare
241
What demographic is commonly affected by adrenal cortical cancer? 2 (hyper functional and nonfunctional)
1. Hyperfunctional - females
2. Nonfuncfional - males
242
What are adrenal cortical cancers typically?
Typically adenocarcinomas
243
What are four presentations of adrenal cortical cancers? 4 (Diseases and how they present)
1. Cushing’s syndrome
2. Conns disease
3. Viralization/ Feminiztion
4. Precocious puberty
244
What is the sonographic appearance of adrenal cortical cancers? 4
1. Well defined, solid mass
2. Variable echogenicity
3. Regional and nodal metastases
4. Possible calcifications
245
Neuroblastoma are benign or malignant?
Highly Malignant
246
What demographic of individuals are affected by neuroblastoma?
4-5 years
247
Neuroblastoma present with what S/S? 4
1. Palpable mass
2. Weight loss
3. Failure to thrive
4. Highly irritable
248
What are the sonographic appearance of neuroblastomas? 6
1. Solid
2. Heterogenous
3. Poorly defined
4. Calcifications
5. Renal displacement
6. Mets
249
What does this represent?
Neuroblastoma
250
What are some risk factors of mesothelioma?
Who is likely affected?
1. Asbestos exposure
2. Middle age men
251
What does mesotheliomas look like on U/S ? 3
1. Omental caking
2. Peritoneal thickening
3. Ascites
252
What does this demonstrate?
Mesothelioma
253
What are the most common sites for metastases? 4
1. Lung
2. Liver
3. Bone
4. Adrenal
254
What is the most common malignant Metastatic tumor in the liver?
METS
255
METS to the liver affect what other organs? 6
1. GB
2. Colon
3. Stomach
4. Pancreas
5. Breast
6. Lung
256
What does METS to the liver look like? 2
1. Multiple solid lesions
2. Hypo halo (highly suggested of met)
257
What are some symptoms of METS to the liver? 5
1. Hepatomegaly
2. Jaundice
3. Pain
4. Nutritional wasting
5. Muscle deterioration
258
What does this demonstrate?
Mets to the liver
259
What are enzymes affected by METS? 4
1. LFT abnormal Increased
2. ALK PHOS
3. AST
4. ALT
260
What is there to know about METs to the spleen? 2 (occurrence, stage)
1. Rare
2. Later stages of processes
261
Is Mets to GB not assocaited with stones?
Gallstones
262
How common is it to see Mets to the pancrease?
Uncommon because Mets tend to occur in the very late stages of disease
263
Mets to the pancreas present as what?
Small hypoechoic mass
264
How common is METS to the kidneys?
Common
265
METS to the kidney's travel from what? 3
From lung, breast and contralateral kidney
266
What is the appearance of Mets to the kidney?
Variable appearance
267
Metastatic lymphoma to the kidney look like what sonographically? 3
1. Nonspecific renal enlargement
2. Hypoechoic diffusely
3. Look for displacement of organs or vessels
268
What does this image demonstrate?
Metastatic lymphoma
269
How common is Mets to the bladder?
Rare
270
How common is GI tract Mets?
Rare
271
What is the most common or frequent site of GI neoplasms?
Stomach most frequent site followed by small bowel then colon
272
How does GI tract neoplasm look like on U/S ? What else is seen besides mass?
1. Large, hypo, well defined masses
2. Ring down artifact
273
What is the 4th most frequent site of METS?
Adrenal
274
How does Mets to the adrenal look? 2
1. May be bilateral
2. Solid, well defind, hypoehoic
275
How does Mets to the adrenal travel?
From lung, breast, and melanoma primaries
276
How does Mets to the retroperitoneum travel?
Via lymph, direct extension or blood
277
What is the most common mets to the retroperitoneum?
Testicular or pelvic tumor most common
278
Mets to the abdominal wall is typically from what?
Malignant melanoma
279
What does Mets to abdominal wall look like sonographically?
1. Hypoechoic mass
2. Posterior enhancement
280
How does peritoneal carcinomatosis look like? 4
1. Hypoechoic mass
2. Thickening of peritoneum (omental caking
3. Ascites
4. Lymphadenopathy
281
What is peritoneal carcinomatosis?
Diffuse metastatic invovlement of the peritoneum
282
Pseudomyxoma peritonei nearly always originates from what?
Perforated appendiceal epithelial tumor
283
What are pseudomyxoma peritonei characteristics? 2
1. Rare, variable prognosis
2. complex, gelatinous ascites
284
What does pseudomyxoma peritonei look like sonographically?
1. Complex ascites
2. Non mobile bowel loops with posterior and central displacement - starburst appearance
285
What does this demonstrate?
Starburst appearance
