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DMST ABD 3 > Neoplastic Diseases > Flashcards

Neoplastic Diseases Flashcards

1
Q

What is a neoplasm? What kind of growth is it?

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

What can we describe a neoplasm 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 for women?

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 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? 2

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? (Proliferation of 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 in the gallbladder are commonly referred to as what?

A

Polyps

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69
Q

What is the sonographic appearance of the pancreas? 4 (comparison to the liver, duct location, echo texture)

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 of the organ?)

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? What is another s/s seen with this?

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? (Adrenal)

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? (Age and side)

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? Where does it usually affect?

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 (route)

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 (in the liver)

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? 4

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 (Areas affected)

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 (What it looks like and what can happen at later stages)

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 does biliary adenocarcinomas look like sonographically? 3

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

What are indirect signs of adenocarcinomas? 2 (pancreas)

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 (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)

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 (Segment involved, thickening, layer)

A
  1. Short segment affected
  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 (organs) 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 (s/s)

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 (s/s)

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? What is the most common symptom seen with it?

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 tumors? 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? What is affected?

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? What is seen above the mass?

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

How does Squamous cell carcinoma look and present like?

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? Where does it spread?

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? 6

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 (small, large, contour, Calc)

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 (hyper functional and nonfunctional)

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

What are adrenal cortical cancers typically?

A

Typically adenocarcinomas

243
Q

What are four presentations of adrenal cortical cancers? 4 (Diseases and how they present)

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?
Who is likely affected?

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 Metastatic tumor in the liver?

A

METS

255
Q

METS to the liver affect what other organs? 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? 4

A
  1. LFT abnormal Increased
  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 from what? 3

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? 3

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 ? What else is seen besides mass?

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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