Neoplastic Diseases Flashcards
What is the most common benign tumour of the liver?
Hemangioma
What is a hemangioma?
A small mass of blood capillaries that usually appear well defined, homogenous and hyperechoic (may have heterogenous, hypoechoic center)
How big are hemangiomas?
Small, typically less than 3 cm
What neoplasms affect women more often and why?
- Hemangioma
- Focal Nodular Hyperplasia
The are influenced by hormones
When may hemangiomas increase in size?
Pregnancy or estrogen therapy
What is done when a hemagioma is found?
6 month follow up to detect changes
What is the name of the neoplasm that is defined as a “hyperplastic lesion containing normal liver tissue”?
Focal Nodular Hyperplasia
How big are focal nodular hyperplasia neoplasms?
Less than 8 cm
How do focal nodular hyperplasia neoplasms appear on US?
Subtle, “stealth lesions”, with a central area of decreased echogenicity and doppler flow centrally
What nuc med test can detect focal nodular hyperplasia neoplasms and what is the result?
Sulpher colloid scan
“Hot or warm”
What neoplasm has a similar appearance to focal nodular hyperplasia but is less common?
Adenoma
What neoplasm of the liver is linked to oral contraceptives?
Adenomas
What disease is adenoma linked to?
Type 1 GSD
AKA:
Von Gierke’s disease
What is type 1 GSD or von Gierke’s disease?
Glycogen storage disease where glycogen builds up in body tissues
Why can adenomas be dangerous?
The can hemorrhage or infarct
How do adenomas appear on US?
Non-specific, usually hyperechoic but can be variable, doppler shows central flow
How big are adenomas?
Large, 8-15 cm
How do adenomas appear on sulfur colloid scans?
“Cold”
What rare benign neoplasm has a very similar appearance to a hemangioma?
Lipoma
What other tests are used to assess benign neoplasms of the liver?
- Contrast CT or MRI
- Red blood cell scintigraphy
- Sulpher Colloid scans-nuclear medicine
- Micro bubble enhance US
- Biopsy
For what benign liver neoplasm is surgery recommended and why?
Adenoma because of their large size and tendancy to hemorrhage
What are the benign neoplasms of the spleen?
- Cavernous hemangioma
- Hamartoma
- Lymphangioma
What is the most common benign neoplasm of the spleen?
Cavernous hemangioma
What benign neoplasm of the spleen is congenital?
Cavernous hemangioma
How do cavernous hemangiomas appear on US?
Variable, hyperechoic to complex with cystic degeneration
What is a hamartoma?
A rare, benign neoplasm of the spleen involving the lymphoid tissue
How do hamartomas appear on US?
Homogenous, solid, echogenic and not-encapsulated.
What benign neoplasm of the spleen is the result or a rare lymphatic malformation?
Lymphangioma
How do lymphangiomas appear on US?
Variable
What is cystic lymphangiomyomatosis?
A benign, multi-loculated cystic mass of the spleen (multiple walls/sepatations)
Are adenomas of the gallbladder true neoplasms?
Yes
How do adenomas of the GB appear on US?
Pedunculated, hyperechoic and homogenous, hypovascular
How big are adenomas of the gall bladder?
Less than 10 mm
What does pedunculated mean?
Polyps or stalks
What neoplasm is an accumulation of cholesterol in the GB wall?
Cholesterolosis
What are the types of cholesterolosis?
- Cholesterolosis (strawberry GB)
2. Cholesterol polyps
How do cholesterolosis appear on US?
Multiple non-shadowing masses (“seeds”) fixed to GB wall
Strawberry GB
What bening neoplasm of the GB looks identical to adenomas but is more likely?
Cholesterol polyp
Can you differentiate between adenomas cholesterol polyps on US?
No
What benign neoplasm is an exaggeration of the RA sinuses?
Adenomyomatosis
What is adenomyomatosis a proliferation of?
The smooth muscle wall of the GB
Where is adenomyomatosis most commonly located?
The GB fundus
If the mid-portion of the GB is affected by adenomyomatosis how does the GB appear?
“Hourglass” shaped
What benign neoplasm is marked by the comet tail artifact?
Adenomyomatosis appears as hyperechoic foci in the GB wall with comet tail
What are adenomyomas?
Focal, mass like area of adenomyomatosis
What is the most common benign neoplasm of the pancreas?
Islet cell tumors
Are islet cell tumors benign or malignant?
Can be either
Are benign islet cell tumors functioning?
Yes,
Benign = functioning
Malignant = Non-functioning
What is the most common type of islet cell tumor?
Bening Insulinoma (located in body or tail)
How do islet cell tumors appear on US?
Well encapsulated, solid, hypoechoic (large ones may be slightly echogenic), variable in size
What is another name for renal hamartoma?
Angiomyolipoma (AML)
Where are angiomyolipomas located?
In the renal cortex
What are angiomyolipomas composed of?
Fat, muscle, and blood vessels
Who most commonly has angiomyolipomas?
Middle aged females
How do angiomyolipomas appear on US?
Hyperechoic, well defined, usually unilateral, low blood flow
What can angiomyolipmas mimic?
RCC
What benign neoplasm is associated with tuberous sclerosis?
Angiomyolipoma (when bilateral and multiple)
What is tuberous sclerosis?
Condition of “fits and zits”, seizures and benign skin growths
What is the diff between adenoma and oncocytoma of the kidney?
Adenoma = less than 3 cm
Oncocytoma = Greater than 3 cm
Do adenoma/oncocytoma give symptoms?
Possible hematuria and pain
Who do adenoma/oncocytoma more commonly affect?
Males in the 6th and 7th decades
What may adenoma/oncocytoma mimic?
RCC
How do adenomas/oncocytoma appear?
Well defined, hypoechoic or isoechoic
Where do adenomas of the adrenal gland arise from?
Adenal cortex
Are adenomas of the adrenal gland functioning?
Hyperfunctioning or non-functioning
What can hyperfunctioning adenomas of the adrenal gland result in?
Endocrine abnormalities such as:
- Cushings syndrome
- Conn’s disease
What is Conn;s disease due to?
Excess aldosterone due to endocrine abnormality from hyperfunctioning adenoma of the adrenal glad
What are myelolipoma?
A rare, non-functioning neoplasm of the adrenal gland
What benign neoplasm of the adrenal gland may arise from the zona fasciculate?
Myelolipoma
Who does mylolipoma mor commonly affect?
Males equal to females in the 5th and 6th decades
How do myelolipomas appear on US?
Hyperechoic
How big are myelolipomas?
Less than 5 cm
What artifact are myelolipomas marked by?
Propogation speed artifact (broken diaphragm)
What is the benign neoplasm of the adrenal gland that is a hyperfunctioning tumor or the medulla?
Pheochromocytoma
What symptoms accompany pheochromocytoma?
Hypertension, palpitations, tachycardia, excessive sweating, urinary catecholamines elevated
Who does phenochromocytoma most commonly affect?
4th and 5th decade, right more common than left
What diseases is pheochromocytoma associated with?
Tuberous sclerosis and MEN syndrome
What is MEN syndrome?
Multiple Endocrine Neoplasia (multiple tumors in the endocrine glands)
What is the sonographic appearance of phenochromocytoma?
Solid, unilaterl encapsulated, hypoechoic
How big are pheochromocytoma?
Less than 2 cm
What do desmoid tumours arise from?
Connective tissue in the abdominal wall
What is the most common tumour of the abdominal wall?
Desmoid
Where are desmoids usually located?
Anterior abdominal wall (at surgical or lapriscopic site)
What are desmoids associated to?
Post-partum
Who do desmoids affect?
More often females, 20-40 years old
How do desmoids appear on US?
Hypoechoic, homogenous that grow slowly but infiltrate locally
What is a lipoma?
A benign neoplasm of the abdominal wall composed of fat that is mobile, soft and compressible
How do lipomas appear on US?
Slightly echogenic to highly echogenic
Malignancies still have to be done
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