Benign Lesions in the Liver Flashcards Preview

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Flashcards in Benign Lesions in the Liver Deck (53):
1

Solid liver lesions in older patients are more likely to be what?

Malignant with metastases more common than primary liver cancer in the absence of liver disease

2

WHat are solid liver lesions in patients with chronic liver disease more likely to represent?

Primary Liver Cancer rather than metastases or benign tumour

3

What is the most common solid liver tumour in non cirrhotic patients

Hemangioma (benign)

4

Name 4 benign liver tumours

Hemangioma
Focal nodular hyperplasia
Adenoma
Liver cysts

5

Name the 2 main types of malignant tumours

Primary liver cancers
Metastases

6

What are the 2 types of Primary liver cancers

Hepatocellular carcinoma
Cholangiocarcinoma

7

What is the commonest liver tumour

Hemangioma

8

Describe a hemangioma

A vascular tumour
Usually single and small
Well demarcated capsule
Usually asymptomatic

9

How do we diagnose a Hemangioma

Ultrasound is key
CT
MRI

10

What is the treatment for hemangioma

No treatment

11

Describe a focal nodular hyperplasia

enign nodule formation of normal liver tissue
congenital anomaly

12

What is the classic appearance of a focal nodular hyperplasia

A central scar through the middle of the mass

13

Who is more likely to have a focal nodular hyperplasia

Young and middle aged women

14

What type of response is a focal nodular hyperplasia?

A hyperplastic response to abnormal arterial flow

15

How can we diagnose a focal nodular hyperplasia

Ultrasound
CT
MRI
Fine needle aspiration

16

What is the treatment for Focal nodular hyperplasia

No treatment
No change is required for pregnancy or hormones

17

What is a hepatic adenoma

Benign neoplasm composed of normal hepatocytes with no portal tract, central veins or bile ducts

18

Who is more likely to get hepatic adenomas?

Women

19

What are hepatic adenomas associated with

The contraceptive hormones - mostly oestrogen

20

What are the symptoms of hepatic adenoma

Usually asymptomatic but may have RUQ pain

21

How might hepatic adenomas present

Rupture, haemorrhage or malignant transformation

22

Where are hepatic adenomas most commonly found

In the right lobe in young women

23

How can regression of hepatic adenomas occur

If the oral contraceptive is discontinued

24

How can we diagnose hepatic adenoma

US
CT
MRI
FNA

25

What is the treatment for hepatic adenomas

Stop the hormones and observe every 6 months for 2 years
If there is no regression then surgical incision may be appropriate

26

What liver structures do adenomas contain

Purely hepatocyte tumours

27

What liver structures do focal nodular hyperplasias contain

All of the liver ultrastructure - RES and bile ductules

28

What type of benign tumour imay bleed

Adenoma

29

What type of benign tumour has the risk of developing into a malignant tumour

Adenoma

30

How can you describe both adenomas and focal nodular hyperplasia

Hypervascular

31

What is a simple cyst

A liquid collection lined by an epithelium

32

What do simple cysts look like on US

Black holes

33

How common are simple cysts in the liver

2nd most common to hemangiomes

34

When would we consider surgical intervention in a simple cyst

If the patient was symptomatic

35

What is the cause of hydatid cysts

Sheep born parasite

36

What can hydatid cysts erode into?

The IVC

37

What is the treatment of a hydatid cyst

Marsupialisation or resection
Albendazole (also used for tapeworms)

38

What is polycystic liver disease a result of

Embryonic ductal plate malformation of the intrahepatic biliary tree

39

What are the 3 types of polycystic liver disease

Von Meyenburg complexes
Polycystic liver disease
Autosomal dominant polycystic kidney disease

40

What is the most common form of PLD

Autosomal recessive

41

What are Von Meyenburg complexes

Benign cystic nodules throughout the liver

42

When do Von Meyenburg complexes occur

During liver development

43

What do the symptoms of PCLD depend on

The size of the cysts

44

What is the main What does autosomal dominant polycystic kidney disease result in

Renal failure

45

What is the main method of managing polycystic liver disease

Conservative treatment

46

What drug is used in PLD for symptom relief and liver volume reduction

Somatostatin

47

What are the 3 common symptoms of a liver abscess

high fever
Leukocytosis
Abdominal Pain

48

Who tends to appear more unwell a patient with a liver abscess or a patient with metastasis?

Liver abscess

49

What is the common history of a patient with liver abscess

Abdominal or biliary infection
Dental procedure (rare)

50

What is the treatment for a liver abscess treatment

Initial broad spectrum antibiotics
Aspiration/ drainage

51

Why do we do an ECHO on patients with a liver abscess

To rule out bacterial endocarditis

52

What do we do for a patient if there is no clinical improvement?

Open drainage and resection

53

What is the minimum number of weeks of atibiotic therapy for a liver abscess patient

4 weeks

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