Neoplastic Diseases: Benign Flashcards
Neoplasms
Tumor/ lesion ~abnormal tissue growth ~diffuse or focal ~benign or malignant ~distinct mass or ill-defined
Abnormal tissue growth is due to
Cells proliferating at a faster rate
Malignant neoplasms can be
Primary or metastatic
Primary malignancies
Mass that originates from a organ
Metastatic malignancies
Mass that originates from a organ and spreads to a different organ
Benign neoplasms
~typically asymptomatic ~have no altered lab tests ~well defined and encapsulated ~slow growing, does not metastasize ~hypovascular or avascular
Benign neoplasms of the liver
Hemangioma
Focal nodular hyperplasia
Adenomas
Lipoma
Hemangioma is a tumor of
blood vessels
The most common benign tumor of the liver
Hemangioma
Hemangioma are
~Women>Men (5:1)
~Asymptomatic
Hemangioma may increase in size during
Pregnancy or with the use of estrogen therapy(HRT’s)
What is the sonographic appearance of a hemangioma
Small (typically <3cm) Well defined Homogenous Hyperechoic Can include a heterogenous central component or hypoechoic central area
When using Doppler on a hemangioma, will it register the slow flow?
No, because the flow is so slow that the Doppler cannot go low enough to register it which is why flow in a hemangioma is not typically detected with ultrasound
What does a hemangioma require
6-month follow up to detect any change
Echogencity is always relative to
Whether the organ is health or not
FNH
Focal nodular hyperplasia
What is focal nodular hyperplasia
Hyperplasia lesion containing normal liver tissue
FNH is >in women than men probably because it is
Influenced by hormones
Is FNH asymptomatic or symptomatic
Asymptomatic
What is the sonographic appearance of FNH
Subtle- “stealth lesion”
<8cm
Central area w/ decreased echogenicity (central scar)
Doppler flow centrally
Because FNH is a stealth “leasion” what do you look for
Contour abnormalities
Displaced vessels
What is the appearance of FNH on a sulpher colloid scan
Hot or warm
Are adenomas more or less common than FNH
Less
Adenomas are linked to
Oral contraceptives
Type 1 GSD
Von Gierke’s disease
Adenomas can cause
Hemorrhage or infarct; with extreme amount of pain
Adenomas are
Usually asymptomatic
What is the sonographic appearance of an adenoma
Non-specific; usually hyperechoic but can be variable
Measures 8-15cm
Solid, solitary and well encapsulated
Doppler shows central area of colour
What is the appearance of an adenoma on a Sulphur colloid scan
Cold
Lipomas in the liver are
Very rare
Usually asymptomatic
What is the sonographic appearance of a liver lipoma
Hyperechoic, very similar appearance to a hemangioma
What are the different ways to test for benign neoplasms of the liver
Contrast enhanced CT or MRI Red blood scintigraphy Sulphur Colloid scan Micro bubble enhanced sonography Biopsy
A Sulphur Colloid Scan is a
Nuclear medicine test
What is the treatment for a liver hemangioma
Repeat US in 3-6months to check for changes
What is the treatment for FNH
Conservative, depending on size
What is the treatment for a liver adenoma
Surgery is recommended due to risk of rupture
What is the treatment for an liver lipoma
Conservative
Are benign neoplasms of the spleen rare
Yes
What is another name for hemangioma
Cavernous hemangioma
Cavernous hemangioma are
Congenital
Most common benign neoplasm of the spleen ‘
Asymptomatic
Are cavernous hemangioma on US a conclusive finding
No, due to its variable appearance
What is the sonographic appearance of a cavernous hemangioma
Variable
Hyperechoic to complex with cystic degeneration
Hamartoma are
Rare
Arise from lymphoid tissue
What is the sonographic appearance of a hamartoma
Homogeneous
Solid
Echogenic
Not encapsulated
Lymphangioma are
Rare
Arise from a lymphatic malformation
What is the sonographic appearance of a lymphangioma
Variable
Multi-loculated means
Lots of septations and walled off masses
Cystic lymphangiomyomatoisis
Multi-loculated cystic mass
Adenoma of the GB
True neoplasm; polyp like growth and has a stalk
Pedunculated
Asymptotic
What is the sonographic appearance of GB adenoma
Hyperechoic
Homogeneous
<10mm
Hypovascular
Cholesterolsis of the GB is a
Accumulation of cholesterol in the GB wall
What are the 2 types of cholesterolosis
Cholesterolosis
Cholesterol polyp
What is cholesterolosis
Strawberry GB
Multi non- shadowing masses fixed to the GB wall
What is a cholesterol polyp
Focal form of cholesterolosis
Can’t be differeianted from an adenoma with US
65% of polyps are what kind
Cholesterol
5% of polyps are
Adenomas
What kind of polyp is the only true polyp
Adenoma
Adenomyomatosis of the GB is the
Exaggeration of the RA sinuses
Proliferation of the smooth wall of the GB; muscle wall is thicker
Adenomyomatosis can be and typically occurs at the
Focal
Diffuse
GB fundus
Is the mid portion of the GB is affected by adenomyomatosis what shape does it creat
Hourglass
What is the sonographic appearance of GB adenomyomatosis
Hyperechoic Foci in the GB wall with a comet tail artifact
Adenomyomas are
Focal
Mass-like area of adenomyomatosis
Benign neoplasms of the pancreas are
Islet cell tumors
Islets cell tumors are _____ and can be
The most common
Benign or malignant
What % of islet cell tumors can be functioning
85
What % of islet cell tumors are non-functioning
15
What is the most common type of islet cell tumor
Insulinoma
Insulinoma are ___ and are typically located in the
Benign
Body or tail
What is the sonographic appearance of islet cell tumors
Well encapsulated
Solid
Usually hypoechoic; larger tumors may be slightly/moderately echogenic
Vary in size
Benign neoplasms of the urinary tract are
Andiomyolipoma (renal hamartoma)
Adenoma/oncocytoma
What is another name for angiomyolipoma of the urinary tract
Renal hamartoma
Renal harmatomas are typically located where? And are composed of ?
Renal cortex
Fat
Muscle
Blood vessels
Renal harmatomas are the most common in what population
Middle aged females
Are renal harmatomas asymptomatic or symptomatic
Asymptomatic
What is the sonographic appearance of renal harmatomas
Hyperechoic
Well defined
Typically unilateral
Low blood flow
What can mimic renal cell carcinoma
Renal harmatomas
What is associated with tuberous sclerosis and what will patients usually form after being diagnosed with this condition before hand
Renal harmatomas; bilateral
AML
Renal harmatomas can blend into what that makes it hard to differentiate the mass
Perirenal fat
Adenoma and oncocytoma are esstenially identical and effect the same area but are only differentiated by ____ and can mimic
Size
Renal cell CA
Adenoma of the urinary tract measure
<3cm
Oncocytoma measure
> 3cm
Adenoma/oncocytoma are typically ____ but sometimes has possible _____
Asymptomatic
Hematuria, pain
Adenoma/oncocytoma typically occur in ___ during
Males
6-7 decade of life
What is the sonographic appearance of adenoma/oncocytoma
Well defined
Hyperechoic or isoechoic
What are the benign neoplasms of the adrenal gland
Adenoma
Myelolipoma
Pheochromocytoma
What benign mass arises from the adrenal cortex and is commonly unilateral
Adenoma of the adrenal gland
Adenomas of the adrenal gland can be either
Hyperfunctioning or non-functioning
Hyperfunctioning adenomas of the adrenal gland can result in
Endocrine abnormalities
What are the endocrine abnormalities that are caused by a hyperfunctioning adenoma
Cushing’s disease
Conn’s disease
Cushing’s disease is an excess of
Cortisol
Conn’s disease is an excess of
Aldosterone
What is the sonographic appearance of a adrenal adenoma
Solid Round Hypoechoic Encapsulated W/ possible calcifications
If a mass does not connect to the liver or kidneys what kind of mass should be considered
Adrenal tumour
What is a rare mass, that is formed from the bone marrow, that arises from the zona fasiculatate and is typically asymptomatic
Myelolipoma
Are myelolipoma of the adrenal gland functioning or non-functioning
Non-functioning
Myelolipoma of the adrenal occurs in what population
Male and female population that are in their 5-6th decade of life
What is the sonographic appearance of myelolipoma of the adrenals
Hyperechoic
Typically measures <5cm
Has a propagation speed artifact
can blend into the perirenal fat
What do you call a hyperfunctioning tumor of the adrenal medulla
Pheochromocytoma
A patient with pheochromocytoma of the adrenal can present with and what lab test will be elevated
Hypertension
Palpitations
Tachycardia
Excessive sweating
Urinary catecholamines will be elevated
Pheochromocytoma of the adrenals typically occurs
In the right adrenal and in the 4-5th decades of life
Pheochromocytoma of the adrenal gland is associated with
Tuberculosis sclerosis
MEN syndrome
what is MEN syndrome
Multiple endocrine neoplasia
What is the sonographic appearance of pheochromocytoma of the adrenal gland
Solid Unilateral Encapsulated Hypoechoic Homogeneous or heterogenous >2cm
Patients can have multiple tumors in their endocrine glands that are both
Malignant and benign
The pancreatic tail can be displaced anteriorly, which is a sign that there is what kind of tumor
Adrenal
What are the benign neoplasms of the abdominal wall
Dermoid tumor
Lipoma
What is the most common tumor of the abdominal wall
Desmoid tumor
Desmoid tumors of the abdominal wall arises from
Connective tissue
What are the 2 types of connective tissues
Aponeurosis
Fascia
Desmoid tumor of the abdominal wall are usually located ____ and have what kind of association
In the anterior abdominal wall, @ surgical or laparoscopic sites
- post-partum association
Desmoid tumor of the abdominal wall typically occurs more commonly in
Females that are 20-40 yrs in age
What is the sonographic appearance of a desmoid tumor of the abdominal wall
Hypoechoic
Homogenous
Lipoma of the abdominal wall are
Composed of fat
Mobile
Soft on palpitation, compressible
What is the sonographic appearance of a abdominal wall lipoma
Variable, ranging from slightly echogenic to highly echogenic