Liver Part 3

Question 1

4 types of malignant hepatic neoplasms

Answer 1

Hepatocellular carcinoma (HCC)
Fibrolamellar carcinoma
Hemangiosarcoma
Hapatic epitheliod hemangioendothelioma

Question 2

One of the most common malignant tumours

Answer 2

Hepatoma / HCC

Question 3

Hepatoma/ HCC more common in waht gender

Answer 3

Males

Question 4

Causes of HCC/hepatoma (4)

Answer 4

Alcoholic cirrhosis
Viral hep B&C
Fatty liver
Toxins

Question 5

Clinical presentation of HCC often delayed until tumor reaches an

Answer 5

Advanced stage

Question 6

Symptoms of HCC (3)

Answer 6

RUQ pain
Weight loss
Abdominal swelling with ascites

Question 7

HCC has invasion of portal vein in ___- ___ % of cases

Answer 7

30-60%

Question 8

Budd chiari symptom is when

Answer 8

HCC invades hepatic venous system

Question 9

Sonographic appearance of HCC

Answer 9

Hypoechoic, complex or hyper
Smaller nodules
May have hypoechoic halo
Necrosis and fibrosis may be seen over time

Question 10

Fibrolamellar carcinoma is subtype of

Answer 10

HCC

Question 11

Distinguishing character of fibromellar carcinoma

Answer 11

Central echogenic scar

Question 12

Hemangiosarcomas are (4)

Answer 12

Rare
Seen in older adults
Associated with specific carcinogens
Mis echogenicity mass

Question 13

Hepatic ecpitheliod (4)

Answer 13

Rare
Occurs in adults
Soft tissues, lungs and liver
Multiple hypoechoic nodules

Question 14

What does neoplasm mean

Answer 14

Tumour

Question 15

Common primary tumors resulting in liver metastases are from

Answer 15

GB 
Colon 
Stomach 
Panc 
Breast
Lung

Question 16

Blood borne routes from metastic liver

Answer 16

Hepatic A, portal vein

Question 17

Lymphatic spread of metastic liver disease

Answer 17

Stomach,
Panc
Ovary
Uterus

Question 18

Tumor cells from the GI tract are drain through

Answer 18

Portal system to the liver

Question 19

Mets are

Answer 19

Single or multifocal liver lesions with identical sonographic morphology

Question 20

Mets wit hhypoechoic halo strongly signs _______

Answer 20

Malignancy

Question 21

Common echogenic patterns of metastic disease (7)

Answer 21

Gi tract 
HCC 
vascular primaries 
Islet cell carcinoma 
Carcinoid 
Choriocarcinoma 
Renal cell carcinoma

Question 22

commmon Hypoechoic patterns of metastatic disease (6)

Answer 22

Breast 
Lung 
Lymphoma 
Esophagus 
Stomach 
Pancreas

Question 23

Echogenic metastatic disease tends to arise from ____ or ______

Answer 23

GI tract or HCC

Question 24

Echogenic metastatic disease is generally _____vascular

Answer 24

Hypervascular

Question 25

Echogenic metastatic disease may mimic ________ on sonography

Answer 25

Hemangioma

Question 26

Hypoechoic metastatic disease generally is ______vascular

Answer 26

Hypovascular

Question 27

Bulls eye or target is typically seen with

Answer 27

Lung cancer

Question 28

Bulls eye or target appearance is

Answer 28

Hypoechoic peripheral halo Nonspecific and common appearance

Question 29

5 calcified metastases

Answer 29

``` Mucinous adenocarcinoma Osteogenic sarcoma Chondrosarcoma Tetratocarcinoma Neuroblastoma ```

Question 30

Shadowing in the liver is most often due to

Answer 30

Calcifications Air Stones Fat containing legions

Question 31

Clean shadow is causesd by

Answer 31

Calcifications

Question 32

Dirty shadow caused by

Answer 32

Air

Question 33

What is the most common cause of a calcified liver tumour

Answer 33

Metastases

Question 34

3 cystic metastases (mets)

Answer 34

Necrosis- sarcomas Cystadenocarcinoma of ovary and panc Mucinous carcinoma of colon

Question 35

Are cystic metastases distinguishable from simple cysts

Answer 35

Yes

Question 36

Character traits of cystic metastases (4)

Answer 36

Mural nodules Thick walls Internal septations Extensive necrosis

Question 37

Infiltrative mets are seen with (3)

Answer 37

Breast Lung Malignant melanoma

Question 38

Infiltrative metastatic disease diffuse disorganization of

Answer 38

Parenchyma

Question 39

Infiltrative metastatic disease is easy or hard to seen on US

Answer 39

Hard

Question 40

Infiltrative metastatic disease can be confused with

Answer 40

Cirrhosis or fatty liver