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SONOCAN ABD Review > Neoplastic diseases > Flashcards

Neoplastic diseases Flashcards

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1
Q

What are neoplasms?

A

Neoplasms are tumors or abnormal tissue growths where cells proliferate at a faster rate. They can be diffuse or focal, benign or malignant.

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2
Q

What is the difference between benign and malignant neoplasms? 5

A

Benign neoplasms are typically
1. Asymptomatic
2. Well-defined
3. Slow-growing
4. Do not metastasize.
5. Malignant neoplasms can be primary or metastatic and are cancerous.

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3
Q

What are the characteristics of benign neoplasms? 4

A
  1. Benign neoplasms are usually asymptomatic
  2. Have no altered lab tests, are well-defined and encapsulated
  3. Slow-growing
  4. Hypovascular or avascular.
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4
Q

What is a hemangioma? (How common is it, who commonly is affected, how symptomatic is it, what happens during pregnancy)

A
  1. Hemangioma is the most common benign tumor of the liver
  2. More common in women
  3. Typically asymptomatic
  4. May increase in size during pregnancy or estrogen therapy.
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5
Q

What is the sonographic appearance of a hemangioma? 6

A

The sonographic appearance of a hemangioma is
1. Typically small (<3cm)
2. Well-defined
3. Homogeneous
4. Hyperechoic
5. May include a heterogeneous
6. Hypoechoic central area.

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6
Q

What is focal nodular hyperplasia (FNH)? How symptomatic is it? Who is commonly affected?

A
  1. FNH is a hyperplastic lesion containing all elements of normal liver tissue
  2. More common in women
  3. Typically asymptomatic.
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7
Q

What is the sonographic appearance of focal nodular hyperplasia? 3

A
  1. FNH appears as a subtle ‘stealth lesion’ with contour abnormalities
  2. <8cm in size, a central area of decreased echogenicity
  3. Central Doppler flow.
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8
Q

What are adenomas in the liver? 4

A
  1. Adenomas are less common than FNH
  2. Linked to oral contraceptives and type 1 GSD
  3. Usually asymptomatic
  4. Can hemorrhage or infarct.
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9
Q

What is the sonographic appearance of liver adenomas? 4

A
  1. Adenomas typically appear as solid
  2. Solitary
  3. Well-encapsulated masses
  4. Usually hyperechoic but can be variable in echogenicity.
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10
Q

What is a lipoma? How does it usually appear?

A

Lipoma is a very rare benign tumor that is usually asymptomatic and appears hyperechoic on sonography.

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11
Q

What are the treatment options for hemangiomas?

A

The treatment for hemangiomas typically involves repeat ultrasound in 3-6 months to check for changes.

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12
Q

Cavernous hemangioma is the most common benign neoplasm of what organ? How symptomatic is it?

A

Cavernous hemangioma is the most common benign neoplasm of the spleen, congenital, and usually asymptomatic.

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13
Q

What is the sonographic appearance of a cavernous hemangioma? 2

A

The sonographic appearance of a cavernous hemangioma is
1. Variable
2. Ranging from hyperechoic to complex with cystic degeneration.

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14
Q

What is a hamartoma? How does it appear? 4

A
  1. Hamartoma is a rare benign neoplasm composed of lymphoid tissue
  2. Appearing homogeneous
  3. Solid
  4. Echogenic on sonography.
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15
Q

What is an adenoma in the gallbladder? How symptomatic is it? How does it appear sonographically?

A
  1. Adenoma is a true neoplasm in the gallbladder that is pedunculated
  2. Usually asymptomatic
  3. Appears hyperechoic and homogeneous.
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16
Q

What is cholesterolosis? How is it characterized?

A
  1. Cholesterolosis is the accumulation of cholesterol in the gallbladder wall
  2. Characterized by multiple non-shadowing masses fixed to the gallbladder wall.
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17
Q

What is adenomyomatosis? How does it appear?

A
  1. Adenomyomatosis is an exaggeration of the RA sinuses in the gallbladder, which can be focal or diffuse
  2. Appears as hyperechoic foci with comet tail artifact.
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18
Q

What are islet cell tumors? How serious are these?

A

Islet cell tumors are the most common benign tumors of the pancreas, which can be benign or malignant and functioning or non-functioning.

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19
Q

What is angiomyolipoma? Who is most commonly affected? Is it symptomatic?

A
  1. Angiomyolipoma is a renal hamartoma located in the renal cortex
  2. Most common in middle-aged females
  3. Typically asymptomatic.
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20
Q

What is the sonographic appearance of angiomyolipoma? 2

A
  1. Angiomyolipoma appears hyperechoic and well-defined
  2. Typically unilateral with low blood flow.
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21
Q

What does desmoid tumor arise from? Where is it located? How fast does it grow?

A
  1. Desmoid tumor arises from connective tissue
  2. Usually located in the anterior abdominal wall
  3. Slow-growing but infiltrative locally.
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22
Q

What are malignant neoplasms?

A

Malignant neoplasms are cancerous growths originating from various types of tissue, including carcinomas and sarcomas.

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23
Q

What is the most common malignant neoplasm in the liver? Who is most commonly affected? What is it associated with?

A
  1. HCC is the most common primary malignancy of the live
  2. More common in males
  3. Associated with risk factors like alcoholic cirrhosis and hepatitis.
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24
Q

What is the sonographic appearance of hepatocellular carcinoma? 3

A
  1. HCC typically appears variable
  2. Often hypoechoic with an anechoic halo
  3. May show portal/hepatic venous invasion.
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25
What is hemangiosarcoma? What is it linked to?
1. Hemangiosarcoma is an extremely rare and aggressive malignant tumor with rapid metastatic spread 2. Linked to certain chemical exposures.
26
What is the sonographic appearance of hemangiosarcoma?
Hemangiosarcoma appears as a large mass with mixed echogenicity.
27
What is hepatoblastoma? When does it occur?
Hepatoblastoma is the most common primary liver malignancy in children, typically occurring in those under 5 years of age.
28
What is the sonographic appearance of hepatoblastoma?
1. Hepatoblastoma appears as a single 2. Solid 3. Large mass with mixed echogenicity and poorly defined walls.
29
What is the sonographic appearance of primary malignant neoplasms? 5
1. Single 2. Solid 3. Large mass with mixed echogenicity 4. Poorly defined walls 5. Calcium deposits.
30
What are lymphomas?
Cancers of lymph tissue that can be nodal or extra nodal.
31
What are the characteristics of Hodgkin's lymphoma? 7 (S/S, who it affects, survival rate)
1. Fever 2. Weight loss 3. Anemia 4. Affects younger age group (15-24) and those over 60, males > females 5. Painless lymph node enlargement at clavicle or neck area 6. 25% para-aortic lymphadenopathy 7. Spreads to other organs but has a high survival rate.
32
What are the characteristics of Non-Hodgkin's lymphoma? 7
1. More common in older age groups (> 55-60) 2. 50% para-aortic lymphadenopathy 3. Painless enlargement of neck or axillary nodes 4. Metastasizes to liver and spleen 5. Fever 6. Weight loss 7. Night sweats.
33
What is the sonographic appearance of lymphomas? 7
1. Anechoic 2. Hypoechoic 3. Solid 4. Homogeneous masses 5. Lobulated or scalloped mass 6. Splenomegaly 7. Organ and vessel displacement/compression including 'floating aorta' sign, 'sandwich' sign, and 'silhouette'/'mantle' sign.
34
What defines a single malignant node in sonographic appearance? 3
1. Round or oval shape 2. Eccentric cortical widening 3. Narrow or absent hilum.
35
What is hemangiosarcoma? What is the sonographic appearance? Where does it metastasize?
1. A rare cancer where 70% of patients present with anemia 2. Similar sonographic appearance to a hemangioma 3. Metastasizing to the liver.
36
What type of carcinoma is Gallbladder Carcinoma?
Adenocarcinoma
37
What is Gallbladder Carcinoma associated with?
Gallstones
38
Which gender is more affected by Gallbladder Carcinoma?
Females are more affected than males.
39
In which decades is Gallbladder Carcinoma most commonly diagnosed?
6th and 7th decades
40
What are the signs and symptoms of Gallbladder Carcinoma?
Similar to chronic cholecystitis
41
Where does Gallbladder Carcinoma commonly spread?
To the liver and regional lymph nodes
42
What symptom can occur in the later stages of Gallbladder Carcinoma?
Jaundice due to obstruction
43
What is the sonographic appearance of Gallbladder Carcinoma? 3
1. Polypoid intraluminal lesion with irregular borders 2. Focal or diffuse irregular GB wall thickening 3. Mass from the GB fossa invading the adjacent liver.
44
What type of carcinoma is Cholangiocarcinoma?
Adenocarcinoma of the bile ducts
45
How does Cholangiocarcinoma grow?
Slow growing
46
Which gender is more frequently affected by Cholangiocarcinoma?
Males
47
What are the risk factors for Cholangiocarcinoma? 2
1. Chronic biliary stasis and inflammation 2. History of choledochal cyst or Caroli’s.
48
What are common clinical presentations of Cholangiocarcinoma?
1. Vague symptoms 2. Jaundice 3. Pruritis 4. Elevated serum bilirubin and ALP.
49
What are the three forms of Cholangiocarcinoma?
Intrahepatic, Distal, Hilar (Klatskins)
50
What is the most common form of Cholangiocarcinoma?
Hilar - Klatskins
51
What is the sonographic appearance of Hilar Cholangiocarcinoma?
1. CBD normal 2. Dilated intrahepatic ducts 3. Tumor difficult to appreciate - solid mass at liver hilum, bulging of duct walls.
52
What is the most common malignancy of the pancreas?
Adenocarcinoma
53
What are the associated risk factors for pancreatic adenocarcinoma? 3
1. Smoking 2. Alcohol abuse 3. Diabetes.
54
In which part of the pancreas does adenocarcinoma typically affect?
Typically affects the pancreatic head.
55
What is the typical age range for pancreatic adenocarcinoma?
More common in older males (60-80 years)
56
What is the prognosis for pancreatic adenocarcinoma?
Poor prognosis
57
What lab value is elevated in pancreatic adenocarcinoma?
Elevated lipase
58
What are common clinical presentations of pancreatic adenocarcinoma? 4
1. Weight loss 2. Painless jaundice 3. Nausea and vomiting 4. Change in stools.
59
What are the direct signs of pancreatic adenocarcinoma? 5
1. Ill defined 2. Hypoechoic 3. Solid mass 4. >2cm in size 5. Can be homogeneous or heterogeneous.
60
What are the indirect signs of pancreatic adenocarcinoma? 3
1. Dilated pancreatic duct 2. Bile duct dilation (Double duct sign) 3. Dilated GB (Courvoisier’s GB/palpable mass).
61
What are the characteristics of microcystic neoplasms?
1. More common in women 2. Benign 3. Occur more frequently in the head of the pancreas.
62
What is the sonographic appearance of microcystic neoplasms? 2
1. Well defined 2. Composed of many small cysts < 2cm in size.
63
What are the characteristics of macrocystic neoplasms? (occurrence, malignancy, location, survivability) 4
1. Uncommon 2. Malignant 3. Often located in pancreatic tail 4. Slow growing with good survival rate.
64
What is the sonographic appearance of macrocystic neoplasms? 5
1. Composed of larger cystic areas (>2 cm) 2. Large 3. Encapsulated 4. Usually unilocular 5. May be multilocular.
65
What can be assessed with ultrasound in the GI tract? 7
1. Wall thickness 2. Content of lumen 3. Diameter of bowel 4. Peristalsis 5. Compression 6. Lymphadenopathy 7. Hyperemia.
66
What is the normal wall thickness for a distended bowel?
3mm
67
What is the normal wall thickness for a non-distended bowel?
5mm
68
What is the sonographic pattern of thickened gut in benign conditions? 3
1. Long segment involved 2. Symmetric thickening 3. Layers preserved.
69
What is the sonographic pattern of thickened gut in malignant conditions? 3
1. Short segment involved 2. Asymmetric thickening 3. Destruction of layers.
70
What is the most common malignant tumor of the GI tract?
Adenocarcinoma
71
What is the sonographic appearance of GI tract adenocarcinoma? 5
1. Large masses 2. Typically hypoechoic 3. Thickened gut wall 4. Target pattern 5. Pseudokidney.
72
What is the most common GI tract tumor in children under 10 years of age?
Lymphoma
73
What is the sonographic appearance of lymphoma in the GI tract? 3
1. Hypoechoic 2. Solid nodules 3. Bowel wall may appear as a target lesion.
74
What is the most common malignant renal tumor in adults?
Renal Cell Carcinoma (RCC, Hypernephroma)
75
What is the typical age range for Renal Cell Carcinoma?
Men > women, 50-70 years of age.
76
What are the clinical presentations of Renal Cell Carcinoma? 5
1. Flank pain 2. Gross hematuria 3. Palpable renal mass 4. Weight loss 5. Hypertension.
77
What is the sonographic appearance of Renal Cell Carcinoma? 4
1. Solid 2. Variable echogenicity 3. Possible calcifications 4. Increased flow.
78
What is the most common malignant renal tumor in children?
Nephroblastoma (Wilm’s Tumor)
79
What is the typical age range for Nephroblastoma?
Peak age 3 - 4 years
80
What are the clinical presentations of Nephroblastoma? 5
1. Fever 2. Hematuria 3. Hypertension 4. Palpable mass 5. Anemia.
81
What is the sonographic appearance of Nephroblastoma? 5
1. Large 2. Well defined 3. Solid 4. Unilateral 5. Heterogeneous or homogeneous.
82
What is Transitional Cell Carcinoma (TCC)?
Arises from the epithelial lining of the collecting system.
83
What are the clinical presentations of Transitional Cell Carcinoma?
Gross or microscopic hematuria.
84
What is the sonographic appearance of TCC in the renal sinus?
Ill defined, hypoechoic mass.
85
What is the sonographic appearance of TCC in the bladder?
Focal, non-mobile mass or thickening.
86
What are the clinical presentations of Squamous Cell Carcinoma?
Gross or microscopic hematuria.
87
What is the most commonly diagnosed cancer in men?
Adenocarcinoma of the prostate.
88
What are the clinical presentations of prostate adenocarcinoma? 6
1. Typically asymptomatic 2. + DRE 3. Bone pain 4. Weakness 5. Weight loss 6. PSA elevated.
89
What is the sonographic appearance of prostate adenocarcinoma? 6
1. Small mass 2. Hypoechoic 3. Large mass 4. Isoechoic 5. Hyperechoic 6. Mixed.
90
What is the typical treatment for prostate adenocarcinoma? 4
1. Watchful waiting 2. Cryotherapy 3. Radiation 4. Radical prostatectomy.
91
What is the sonographic appearance of cortical cancer? 3
1. Well defined 2. Solid mass 3. Variable echogenicity.
92
What is Neuroblastoma?
Highly malignant tumor found in children.
93
What is the typical age range for Neuroblastoma?
4-5 years of age.
94
What are the clinical presentations of Neuroblastoma? 4
1. Palpable mass 2. Weight loss 3. Failure to thrive 4. Highly irritable.
95
What is the sonographic appearance of Neuroblastoma? 5
1. Solid 2. Heterogeneous 3. Poorly defined mass 4. Calcifications 5. Renal displacement.
96
What is Mesothelioma?
A rare malignancy associated with asbestos exposure.
97
What is the sonographic appearance of Mesothelioma? 3
1. Omental caking 2. Peritoneal thickening 3. Ascites.
98
What is the most common site for metastatic disease?
Liver
99
What are the common symptoms of liver metastasis? 4
1. Hepatomegaly 2. Jaundice 3. Pain 4. Anorexia.
100
What is the sonographic appearance of liver metastasis? 2
1. Multiple lesions 2. Hypoechoic halo.
101
What is the sonographic appearance of peritoneal carcinomatosis? 3
1. Hypoechoic nodules 2. Masses or thickening of peritoneum 3. Ascites.
102
What is Pseudomyxoma Peritonei? 3
1. Complex 2. Gelatinous ascites 3. Nearly always originates from a perforated appendiceal epithelial tumor.
103
What is the sonographic appearance of Pseudomyxoma Peritonei? 2
1. Complex ascites 2. Non-mobile bowel loops displaced centrally and posteriorly.
104
What is an epithelial tumor?
A rare tumor with a variable and difficult to predict prognosis.
105
What is the sonographic appearance of an epithelial tumor? 2
1. It includes complex ascites 2. non-mobile bowel loops displaced centrally and posteriorly (starburst appearance).

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