Lesson 3B (Part 2) Flashcards Preview

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Flashcards in Lesson 3B (Part 2) Deck (31)
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1

Are cystic neoplasms benign or malignant?

Both
- good patient history is important to help differentiate

2

What do the majority of pseudocysts have?

Cystic lesions
- > 75%

3

What are some imaging features to help with differential diagnosis?

CT and MRI are not reliable when charaterizing when small
- importance of US is to follow patients with cysts 3cm or less in diameter

4

What are high-risk features of cystic pancreatic lesions? (5)

1. Symptomatic Patients
2. Growth on serial examinations
3. Diameter >3cm
4. Internal soft tissue
5. Mural or septal thickening

5

Where are simple cysts rare?

In the pancreas

6

What are examples of inherited diseases with a high prevalence of cysts? (2)

1. Polycystic Kidney Disease
- ADPKD
2. Von Hippel-Lindau Disease
- VHL

7

Von Hippel-Lindau Disease

Is a connective tissue disorder

8

What does multiple simple pancreatic cysts suggest?

VHL

9

What are 3 lesions associated with VHL?

1. Serous cystic neoplasm
2. Pancreatic endocrine tumors
3. Ductal adenocarcinoma

10

Why do you use colour doppler on a benign cyst in the pancreatic tail?

To differentiate from a tortuous splenic artery

11

What are cystic tumours normally?

Benign or low grade malignancies

12

Are mucinous tumours often benign or malignant?

Malignant

13

Who has a great risk for mucinous tumours?

Older individuals

14

What is the most common cystic neoplasms in order of prevalence? (4)

1. Serous cystic
2. Intraductal papillary mucinous
3. Mucinous cystic
4. Solid pseudopapillary

15

What was serous cystic neoplasm previously known as?

Microcystic adenoma

16

Microcystic adenoma

Is a benign tumor that is more frequently found in women that most often occurs in the pancreatic head

17

Whats does serous cystic neoplasm look like sonographically?

1. Myriad of tiny cysts
- too small to be resolved individually with US
2. Echogenic appearance
- due to multiple reflective wall interfaces
3. Posterior enhancement
4. Fibrous pattern may be present
5. Central calcification
- 30-50% of the time

18

IPMN

Intraductal papillary mucinous neoplasm

19

What are 3 other names for intraductal papillary mucinous neoplasm?

1. Intraductal papillary mucinous tumor
2. Intraductal mucin-hyperfunctioning neoplasm
3. Ductectatic mucinous neoplasm

20

Where does IPMN arise from?

The pancreatic ducts
- head region usually

21

Who does IPMN affect more?

The elderly
- men and women equally

22

How does IPMN persist?

As acute pancreatitis

23

Why does IPMN persist as acute pancreatitis?

Due to mucin being secreted into ducts
- duct dilation and sometimes
Mucin travels to ampulla of Vater

24

Is IPMN benign or malignant?

Can be either

25

What is often present in IPMN?

Adenocarcinoma
- 30-70% of the time

26

What is the hallmark on US for IPMN?

Prominent ductal dilation

27

How does mucin appear on US?

Similar to sludge

28

Who is mucinous cystic neoplasm more common in?

Perimenopausal women

29

Where does mucinous cystic neoplasm appear more common?

Pancreatic body & tail

30

What are the sonographic features of mucinous cystic neoplasm? (4)

1. May be unilocular or multilocular
2. Thick or thin wall
3. May have septations
- thick or thin
4. Internal debris is common