GI - Pathology (Liver Part II: Cancer & other conditions) Flashcards Preview

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Flashcards in GI - Pathology (Liver Part II: Cancer & other conditions) Deck (22)
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1
Q

What is the most common primary malignant tumor of the liver in adults? What is another name for it?

A

Hepatocellular carcinoma/hepatoma

2
Q

What are 6 conditions/factors associated with hepatocellular carcinoma/hepatoma?

A

Associated with (1) hepatitis B and C, (2) Wilson disease, (3) hemochromatosis, (4) alpha1-antitrypsin deficiency, (5) alcoholic cirrhosis, and (6) carcinogens (e.g., aflatoxin from Aspergillus)

3
Q

To what complication may hepatocellular carcinoma/hematoma lead?

A

May lead to Budd-Chiari syndrome

4
Q

What are 4 historical/physical exam findings associated with hepatocellular carcinoma/hepatoma?

A

Findings: (1) jaundice (2) tender hepatomegaly (3) ascites (4) anorexia

5
Q

How does hepatocellular carcinoma/hepatoma spread?

A

Spreads hematogenously

6
Q

How is hepatocellular carcinoma/hepatoma diagnosed?

A

Diagnosis: High alpha-fetoprotein; ultrasound or contrast CT

7
Q

Besides hepatocellular carcinoma, what are 3 other liver tumors?

A

(1) Cavernous hemangioma (2) Hepatic adenoma (3) Angiosarcoma

8
Q

Is cavernous hemangioma of the liver common or rare? Is it benign or malignant? Also, at what patient age range does it typically occur?

A

Common, benign liver tumor; typically occurs at age 30-50 years

9
Q

What is important to note about diagnostic methods in cavernous hemangioma, and why?

A

Biopsy contraindicated because of risk of hemorrhage

10
Q

Is hepatic adenoma common or rare? Is it benign or malignant? To what factor/condition(s) is it often related?

A

Rare, benign liver tumor, often related to oral contraceptive or anabolic steroid use

11
Q

What are 2 possible outcomes of hepatic adenoma?

A

May regress spontaneously or rupture (abdominal pain and shock)

12
Q

Is angiosarcoma of the liver benign or malignant? What is its origin?

A

Malignant tumor of endothelial origin

13
Q

With what 2 exposures is angiosarcoma of the liver associated?

A

Associated with exposure to arsenic, vinyl chloride

14
Q

In general, what causes nutmeg liver? Give 2 clinical contexts in which this may occur?

A

Due to back up of blood into liver. Commonly caused by right-sided heart failure and Budd-Chiari syndrome.

15
Q

Briefly describe the appearance of nutmeg liver.

A

The liver appears mottled like a nutmeg

16
Q

What complication can result from persistence of nutmeg liver, and how does it occur?

A

If the condition persists, centrilobular congestion and necrosis can result in cardiac cirrhosis

17
Q

What defines Budd-Chiari syndrome? In what condition does it result, and what are 4 symptoms of that condition?

A

Occlusion of IV or hepatic veins with centrilobular congestion and necrosis, leading to congestive liver disease (hepatomegaly, ascites, abdominal pain, and eventual liver failure).

18
Q

What visible physical findings (positive or negative) may patients with Budd-Chiari develop?

A

May develop varices and have visible abdominal and back veins. Absence of JVD.

19
Q

What are 4 conditions with which budd-chiari syndrome is associated?

A

Associated with (1) hypercoagulable states, (2) polycythemia vera, (3) pregnancy, and (4) HCC

20
Q

What is the pathophysiology of alpha1-antitrypsin deficiency in the liver? What classing clinical finding does this cause?

A

Misfolded gene product protein aggregates in hepatocellular ER => cirrhosis with PAS (+) globules in liver

21
Q

What is the mode of inheritance of alpha1-antitrypsin deficiency?

A

Codominant trait

22
Q

What effects does alpha1-antitrypsin deficiency have in the lungs?

A

In lungs, decreased alpha1-antitrypsin => uninhibited elastase in alveoli => decreased elastic tissue => panacinar emphysema