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SONOCAN ABD Review > Neoplastic diseases > Flashcards

Neoplastic diseases Flashcards

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
Q

What is hemangiosarcoma? What is it linked to?

A
  1. Hemangiosarcoma is an extremely rare and aggressive malignant tumor with rapid metastatic spread
  2. Linked to certain chemical exposures.
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26
Q

What is the sonographic appearance of hemangiosarcoma?

A

Hemangiosarcoma appears as a large mass with mixed echogenicity.

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27
Q

What is hepatoblastoma? When does it occur?

A

Hepatoblastoma is the most common primary liver malignancy in children, typically occurring in those under 5 years of age.

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28
Q

What is the sonographic appearance of hepatoblastoma?

A
  1. Hepatoblastoma appears as a single
  2. Solid
  3. Large mass with mixed echogenicity and poorly defined walls.
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29
Q

What is the sonographic appearance of primary malignant neoplasms? 5

A
  1. Single
  2. Solid
  3. Large mass with mixed echogenicity
  4. Poorly defined walls
  5. Calcium deposits.
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30
Q

What are lymphomas?

A

Cancers of lymph tissue that can be nodal or extra nodal.

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31
Q

What are the characteristics of Hodgkin’s lymphoma? 7 (S/S, who it affects, survival rate)

A
  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.
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32
Q

What are the characteristics of Non-Hodgkin’s lymphoma? 7

A
  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.
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33
Q

What is the sonographic appearance of lymphomas? 7

A
  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.
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34
Q

What defines a single malignant node in sonographic appearance? 3

A
  1. Round or oval shape
  2. Eccentric cortical widening
  3. Narrow or absent hilum.
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35
Q

What is hemangiosarcoma? What is the sonographic appearance? Where does it metastasize?

A
  1. A rare cancer where 70% of patients present with anemia
  2. Similar sonographic appearance to a hemangioma
  3. Metastasizing to the liver.
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36
Q

What type of carcinoma is Gallbladder Carcinoma?

A

Adenocarcinoma

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37
Q

What is Gallbladder Carcinoma associated with?

A

Gallstones

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38
Q

Which gender is more affected by Gallbladder Carcinoma?

A

Females are more affected than males.

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39
Q

In which decades is Gallbladder Carcinoma most commonly diagnosed?

A

6th and 7th decades

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40
Q

What are the signs and symptoms of Gallbladder Carcinoma?

A

Similar to chronic cholecystitis

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41
Q

Where does Gallbladder Carcinoma commonly spread?

A

To the liver and regional lymph nodes

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42
Q

What symptom can occur in the later stages of Gallbladder Carcinoma?

A

Jaundice due to obstruction

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43
Q

What is the sonographic appearance of Gallbladder Carcinoma? 3

A
  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
Q

What type of carcinoma is Cholangiocarcinoma?

A

Adenocarcinoma of the bile ducts

45
Q

How does Cholangiocarcinoma grow?

A

Slow growing

46
Q

Which gender is more frequently affected by Cholangiocarcinoma?

A

Males

47
Q

What are the risk factors for Cholangiocarcinoma? 2

A
  1. Chronic biliary stasis and inflammation
  2. History of choledochal cyst or Caroli’s.
48
Q

What are common clinical presentations of Cholangiocarcinoma?

A
  1. Vague symptoms
  2. Jaundice
  3. Pruritis
  4. Elevated serum bilirubin and ALP.
49
Q

What are the three forms of Cholangiocarcinoma?

A

Intrahepatic, Distal, Hilar (Klatskins)

50
Q

What is the most common form of Cholangiocarcinoma?

A

Hilar - Klatskins

51
Q

What is the sonographic appearance of Hilar Cholangiocarcinoma?

A
  1. CBD normal
  2. Dilated intrahepatic ducts
  3. Tumor difficult to appreciate - solid mass at liver hilum, bulging of duct walls.
52
Q

What is the most common malignancy of the pancreas?

A

Adenocarcinoma

53
Q

What are the associated risk factors for pancreatic adenocarcinoma? 3

A
  1. Smoking
  2. Alcohol abuse
  3. Diabetes.
54
Q

In which part of the pancreas does adenocarcinoma typically affect?

A

Typically affects the pancreatic head.

55
Q

What is the typical age range for pancreatic adenocarcinoma?

A

More common in older males (60-80 years)

56
Q

What is the prognosis for pancreatic adenocarcinoma?

A

Poor prognosis

57
Q

What lab value is elevated in pancreatic adenocarcinoma?

A

Elevated lipase

58
Q

What are common clinical presentations of pancreatic adenocarcinoma? 4

A
  1. Weight loss
  2. Painless jaundice
  3. Nausea and vomiting
  4. Change in stools.
59
Q

What are the direct signs of pancreatic adenocarcinoma? 5

A
  1. Ill defined
  2. Hypoechoic
  3. Solid mass
  4. > 2cm in size
  5. Can be homogeneous or heterogeneous.
60
Q

What are the indirect signs of pancreatic adenocarcinoma? 3

A
  1. Dilated pancreatic duct
  2. Bile duct dilation (Double duct sign)
  3. Dilated GB (Courvoisier’s GB/palpable mass).
61
Q

What are the characteristics of microcystic neoplasms?

A
  1. More common in women
  2. Benign
  3. Occur more frequently in the head of the pancreas.
62
Q

What is the sonographic appearance of microcystic neoplasms? 2

A
  1. Well defined
  2. Composed of many small cysts < 2cm in size.
63
Q

What are the characteristics of macrocystic neoplasms? (occurrence, malignancy, location, survivability) 4

A
  1. Uncommon
  2. Malignant
  3. Often located in pancreatic tail
  4. Slow growing with good survival rate.
64
Q

What is the sonographic appearance of macrocystic neoplasms? 5

A
  1. Composed of larger cystic areas (>2 cm)
  2. Large
  3. Encapsulated
  4. Usually unilocular
  5. May be multilocular.
65
Q

What can be assessed with ultrasound in the GI tract? 7

A
  1. Wall thickness
  2. Content of lumen
  3. Diameter of bowel
  4. Peristalsis
  5. Compression
  6. Lymphadenopathy
  7. Hyperemia.
66
Q

What is the normal wall thickness for a distended bowel?

A

3mm

67
Q

What is the normal wall thickness for a non-distended bowel?

A

5mm

68
Q

What is the sonographic pattern of thickened gut in benign conditions? 3

A
  1. Long segment involved
  2. Symmetric thickening
  3. Layers preserved.
69
Q

What is the sonographic pattern of thickened gut in malignant conditions? 3

A
  1. Short segment involved
  2. Asymmetric thickening
  3. Destruction of layers.
70
Q

What is the most common malignant tumor of the GI tract?

A

Adenocarcinoma

71
Q

What is the sonographic appearance of GI tract adenocarcinoma? 5

A
  1. Large masses
  2. Typically hypoechoic
  3. Thickened gut wall
  4. Target pattern
  5. Pseudokidney.
72
Q

What is the most common GI tract tumor in children under 10 years of age?

A

Lymphoma

73
Q

What is the sonographic appearance of lymphoma in the GI tract? 3

A
  1. Hypoechoic
  2. Solid nodules
  3. Bowel wall may appear as a target lesion.
74
Q

What is the most common malignant renal tumor in adults?

A

Renal Cell Carcinoma (RCC, Hypernephroma)

75
Q

What is the typical age range for Renal Cell Carcinoma?

A

Men > women, 50-70 years of age.

76
Q

What are the clinical presentations of Renal Cell Carcinoma? 5

A
  1. Flank pain
  2. Gross hematuria
  3. Palpable renal mass
  4. Weight loss
  5. Hypertension.
77
Q

What is the sonographic appearance of Renal Cell Carcinoma? 4

A
  1. Solid
  2. Variable echogenicity
  3. Possible calcifications
  4. Increased flow.
78
Q

What is the most common malignant renal tumor in children?

A

Nephroblastoma (Wilm’s Tumor)

79
Q

What is the typical age range for Nephroblastoma?

A

Peak age 3 - 4 years

80
Q

What are the clinical presentations of Nephroblastoma? 5

A
  1. Fever
  2. Hematuria
  3. Hypertension
  4. Palpable mass
  5. Anemia.
81
Q

What is the sonographic appearance of Nephroblastoma? 5

A
  1. Large
  2. Well defined
  3. Solid
  4. Unilateral
  5. Heterogeneous or homogeneous.
82
Q

What is Transitional Cell Carcinoma (TCC)?

A

Arises from the epithelial lining of the collecting system.

83
Q

What are the clinical presentations of Transitional Cell Carcinoma?

A

Gross or microscopic hematuria.

84
Q

What is the sonographic appearance of TCC in the renal sinus?

A

Ill defined, hypoechoic mass.

85
Q

What is the sonographic appearance of TCC in the bladder?

A

Focal, non-mobile mass or thickening.

86
Q

What are the clinical presentations of Squamous Cell Carcinoma?

A

Gross or microscopic hematuria.

87
Q

What is the most commonly diagnosed cancer in men?

A

Adenocarcinoma of the prostate.

88
Q

What are the clinical presentations of prostate adenocarcinoma? 6

A
  1. Typically asymptomatic
    • DRE
  3. Bone pain
  4. Weakness
  5. Weight loss
  6. PSA elevated.
89
Q

What is the sonographic appearance of prostate adenocarcinoma? 6

A
  1. Small mass
  2. Hypoechoic
  3. Large mass
  4. Isoechoic
  5. Hyperechoic
  6. Mixed.
90
Q

What is the typical treatment for prostate adenocarcinoma? 4

A
  1. Watchful waiting
  2. Cryotherapy
  3. Radiation
  4. Radical prostatectomy.
91
Q

What is the sonographic appearance of cortical cancer? 3

A
  1. Well defined
  2. Solid mass
  3. Variable echogenicity.
92
Q

What is Neuroblastoma?

A

Highly malignant tumor found in children.

93
Q

What is the typical age range for Neuroblastoma?

A

4-5 years of age.

94
Q

What are the clinical presentations of Neuroblastoma? 4

A
  1. Palpable mass
  2. Weight loss
  3. Failure to thrive
  4. Highly irritable.
95
Q

What is the sonographic appearance of Neuroblastoma? 5

A
  1. Solid
  2. Heterogeneous
  3. Poorly defined mass
  4. Calcifications
  5. Renal displacement.
96
Q

What is Mesothelioma?

A

A rare malignancy associated with asbestos exposure.

97
Q

What is the sonographic appearance of Mesothelioma? 3

A
  1. Omental caking
  2. Peritoneal thickening
  3. Ascites.
98
Q

What is the most common site for metastatic disease?

A

Liver

99
Q

What are the common symptoms of liver metastasis? 4

A
  1. Hepatomegaly
  2. Jaundice
  3. Pain
  4. Anorexia.
100
Q

What is the sonographic appearance of liver metastasis? 2

A
  1. Multiple lesions
  2. Hypoechoic halo.
101
Q

What is the sonographic appearance of peritoneal carcinomatosis? 3

A
  1. Hypoechoic nodules
  2. Masses or thickening of peritoneum
  3. Ascites.
102
Q

What is Pseudomyxoma Peritonei? 3

A
  1. Complex
  2. Gelatinous ascites
  3. Nearly always originates from a perforated appendiceal epithelial tumor.
103
Q

What is the sonographic appearance of Pseudomyxoma Peritonei? 2

A
  1. Complex ascites
  2. Non-mobile bowel loops displaced centrally and posteriorly.
104
Q

What is an epithelial tumor?

A

A rare tumor with a variable and difficult to predict prognosis.

105
Q

What is the sonographic appearance of an epithelial tumor? 2

A
  1. It includes complex ascites
  2. non-mobile bowel loops displaced centrally and posteriorly (starburst appearance).

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