Cystic Diseases Flashcards
(96 cards)
1
Q
What is the definition of a cyst
A
Walled off collection of fluid
2
Q
Does a true cyst have an epithelial wall
A
Yes
3
Q
True cysts are
A
Congenital
4
Q
What are the two different components of congenital true cysts
A
Hereditary
Developmental
5
Q
Do acquired cysts have an epithelial wall
A
No
6
Q
What are the 2 categories of cysts
A
True
Acquired
7
Q
What period can acquired cysts occur
A
Post traumatic events
Infectious
Parasitic
Inflammatory (abscesses)
8
Q
What are the features of a true cyst
A
Multiple cysts in one organ
Multiple organs with cysts
9
Q
What are the features of acquired cysts
A
A patient’s: history, signs and symptoms
10
Q
What are the 4 sonographic requirements for a simple cyst
A
Anechoic
Strong back wall
Posterior enhancement
Oval or round -> refractive edge shadowing
11
Q
What is the 4 criteria for complex cysts
A
Internal echoes
Septations
Calcifications
Thick wall or mural nodularity
12
Q
Internal echoes are usually indicative of what
A
Hemorrhage
Infection
13
Q
Septations are usually indicative of what
A
Malignancy
Hemorrhage
Infection
Adjacent cysts
14
Q
Calcifications are indicative of what
A
Malignancy
Inflammatory reaction
Milk of calcium
15
Q
Thick wall or mural nodularity is indicative of what
A
Malignancy
Benign thickening
16
Q
age increases occurance of cysts where
A
liver
kidneys
17
Q
cysts are
A
common, often incidental finding in an abdominal scan
18
Q
multiple cysts can indicate what
A
genetic abnormality
19
Q
possible effects are dependent of
A
number
size
location
20
Q
possible effects
A
asymptomatic pain pressure increased lab values jaundice fever
21
Q
majority of cysts are
A
asymptomatic
22
Q
what are the two types of renal cortical cysts
A
simple
complex
23
Q
simple renal cortical cysts are
A
benign have unknown etiology increase with age mostly asymptomatic no required follow-up
24
Q
complex renal cortical cysts do
A
not meet criteria of a simple cyst
requires further imaging
has septations
25
if a complex renal cortical cyst has irregular >1 mm septations or solid elements is present what must be presumed about the lesion
malignant until proven otherwise
26
PKD
polycystic kidney disease
27
what are the 2 types of PKD
autosomal dominant
| autosomal recessive
28
ADPKD
autosomal dominant polycystic kidney disease
29
ADPKD is the most common
hereditary renal disorder
30
ADPKD manifest in
4th decade of life
31
what are the associated anomalies of ADPKD
liver, pancreas and splenic cysts
| cerebral berry aneurysms
32
50% of people with ADPKD develop
renal failure
33
what is the presentation of ADPKD in patients
```
palpable mass
pain
hematuria
hypertension
UTI's
```
34
what is the sonographic appearance of ADPKD
renal enlargement
| multiple bilateral cysts
35
does ADPKD always effect both kidenys
yes
36
what is the most sensitive lab test for kidneys
creatine and then BUN
37
how do you measure ADPKD kidneys
overall size and look for malignant features
38
how does the presentation of ADPKD differ from cortical cysts
there is multiple cyst and they are in the sinus and medulla`
39
ARPKD
autosomal recessive kidney disease
40
what are the 4 ages that are effected by ARPKD
perinatal
neonatal
infantile
juvanile
41
in ARPKD younger children what is more prominent
renal abnormalities
42
in ARPKD older children what is more prominent and what kind
liver abnormalities, more so portal hypertension
43
what are all cases of ARPKD associated with
congenital hepatic fibrosis
44
what is the sonographic appearance of of ARPKD
massively enlarged echogenic kidneys
lose of CM differentiation
macroscopic cysts are also noted occasionally
45
parapelvic cysts are
believed to be lymphatic in origin
located in the sinus
mostly asymptomatic
46
what is the sonographic appearance of parapelvic cysts
well defined cysts
| do not connect to the collecting system
47
what can help differentiate between parapelvic cysts and hydronephrosis
a slow sweep, as parapelvic cysts will be walled off and not connect
OR
IVP/ contrast CT
48
medullary sponge kidney are
dilated (ectatic) collecting tubules
49
what percentage of patients with renal stones are found to have medullary sponge kidneys
12
50
is the etiology of medullary sponge kidneys known
no
51
when are medullary sponge kidneys typically identified
3rd and 4th decades of life
52
what is the sonographic appearance of medullary sponge kidneys
bilateral echogenic pyramids
| may have calcifications present, but localized to the pyramids
53
`medullary cystic disease is
Genetic
| result of progressive renal tubular atrophy
54
what are the 2 types of medullary cystic disease
dominant
| recessive
55
medullary cystic always effects
the kidneys bilaterally
56
what is the sonographic appearance of medullary cystic disease
echogenic kidneys
small measurement
0.1 - 1.0 cm pyramid cysts
57
MCDK
multicystic dysplastic kidney
58
MCDK is
developmental due to a obstruction of ureter in utero
| non-hereditary and affects both male and females as well as both right and left kidneys
59
MCDK is the most common renal cystic disease in what group of the poipulation
children
60
what is the sonographic appearance of MCDK
small, malformed kidney
mulitple, non-communicating cysts
absence of normal renal architecture\
always presents clinically as unilateral
61
what does bilateral MCDK cause
incompatibility for life and is only seen prenatally
62
what is another name for primary congenital cysts
epidermoid cysts of the spleen
63
primary congenital cysts are
rare
| asymptomatic
64
what is the sonographic appearance of primary congenital cysts
echogenic cystic structures
| internal echoes
65
choledochal cysts are found in
eastern Asian population
| female predominantly
66
what is a choledochal cyst and what is it caused by
fusiform dilation of the CBD and is caused by an anomalous insertion of the CBD into the pancreatic duct
67
choledochal cysts have a known association with
cholangiocarcinoma (cancer of the bile duct)
68
what is the sonographic appearance of choledochal cysts
cystic
| can contain sludge, stones or solid neoplasm
69
if a choledochal cyst is large it may be difficult to identify what
the connection to the bile duct
70
what is the most common type of choledochal cyst
type 1
71
what is Caroli's disease
a rare, congenital dilation of the intrahepatic biliary tree
72
what does Caroli's disease result in
statis
stones
cholangitis
sepsis
73
what is the sonographic appearance of Caroli's disease
saccular or fusiform dilation of the intrahepatic bile duct
| often diffuse, may be focal
74
dilated ducts in Caroli's disease often contain
sludge
| stones
75
Caroli's disease has a connection with
ARPKD
| medullary sponge kidneys
76
what is cystic fibrosis and what abdominal organ does it effect
genetic condition
exocrine dysfunction
pancreas
77
what is the sonographic appearance of cystic fibrosis
increased echogencity
| atrophy
78
in cystic fibrosis what is seen on pathology but uncommonly seen sonographically
small, 1-3mm, cysts
79
peritoneal inclusion cysts are
```
adhesion trapped ovarian fluid
ovary encased (trapped in the surrounding scar tissue)
more common in women
```
80
what is the appearance of peritoneal inclusion cysts`
simple to complex
81
mesenteric cysts are
rare
typically an incidental finding
variable in appearance and size
82
what is the origin of mesenteric cysts
lymphatic or mesothelial
83
GI duplication cyst are
filled with anechoic fluid
well defined
have a double layer wall
84
what are the 2 layers of GI duplication cysts
Inner layer: mucosal layer -> echogenic
| Outer layer: muscular layer -> hypoechoic
85
what are the 2 types of prostatic cysts
degenerative
| congenital
86
what are degenerative prostatic cysts
most common
typically located in the transitional zone
have no clinical significance
87
what are congenital prostatic cysts
most asymptomatic
| associated with infertility and hematopspermia`
88
what are the 4 types of congenital prostatic cysts
utricle
Mullerian duct
ejaculatory duct
seminal veslical
89
what does a mullerian duct cyst cause and what does it look like
no spermatozoa
| teardrop shape with a thick wall
90
where is a utricle cyst located and look like and what is it associated with
midline, teardrop shape; usually small but can become large
unilateral renal agenesis
91
what does a ejaculatory duct cyst look like and contain; as well as what is it associated with
fusiform shape
contains spermatozoa
associated with infertility
92
what is a seminal vesicle cyst associated with
ipsilateral renal agenesis when increased in size
93
in cystic diseases what happens to lab tests
LFT's can be elevated and leukocytosis can be present
94
in cystic diseases what can be done after identification
aspiration
biopsy
sent to other imaging modalities; such as CT or X-ray
95
`what are the treatments for cystic diseases
aspiration
alcohol ablation
surgical removal
organ transplant
96
what cystic diseases can cause abnormal LFT's
Caroli's
choledochal cysts
ARPKD
