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Abdomen & Superficial Structures > Malignant Neoplastic Diseases > Flashcards

Malignant Neoplastic Diseases Flashcards

1
Q

Characteristics of malignant neoplasms

A

hypoechoic halo
multiple solid, hypoechoic liver masses
high velocity Doppler/hypervascularity
lymphadenopathy

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2
Q

malignancy of connective tissue origin

A

sarcoma

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3
Q

malignancy of epithelial tissue origin

A

carcinoma

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4
Q

most common type of malignancy

A

adenocarcinomas

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5
Q

high risk factors for malignant neoplasms

A

viruses
family history/genetics
environmental exposures
hormone imbalances

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6
Q

most common primary malignant liver neoplasm

A

HCC

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7
Q

HCC, aka

A

hepatoma

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8
Q

hepatoma, aka

A

HCC

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9
Q

most common malignant neoplasm, overall

A

secondary metastases

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10
Q

gender prevalence of HCC

A

males>females

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11
Q

three forms of HCC

A

solitary focal, multiple focal, diffuse infiltration

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12
Q

risk factors for HCC

A

alcoholism, cirrhosis, Hep B or C, toxic metabolites, metabolic disorders (e.g. GSD)

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13
Q

GSD

A

glycogen storage disease

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14
Q

symptoms of HCC

A

RUQ pain
weight loss
abdominal swelling/ascites
hepatomegaly

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15
Q

appearance of HCC

A

often solitary, usually hypoechoic, anechoic halos

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16
Q

size of HCC

A

less than 5 cm

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17
Q

common site of invasion for HCC

A

portal and hepatic veins

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18
Q

DDx for hyperechoic presentation of HCC

A

hemangioma, adenoma, lipoma

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19
Q

lab values indicative of HCC

A

elevated AFP (most reliable, 70% present) and LFT’s (ALP, AST, ALT)

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20
Q

liver hemangiosarcoma, aka

A

liver angiosarcoma

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21
Q

liver angiosarcoma, aka

A

liver hemangiosarcoma

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22
Q

age prevalence of liver hemangiosarcoma

A

60-80 yrs old

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23
Q

environmental risk factors for liver hemangiosarcoma

A

exposure to arsenic, PVC (industrial chemicals), or thorotrast (xray contrast)

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24
Q

appearance of liver hemangiosarcoma

A

large, mixed echogenicity, necrotic or fibrotic areas due to rapid growth

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25
Q

appearance of epitheloid hemangioendothelioma

A

multiple, hypoechoic, inward retraction of hepatic capsule over the lesion

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26
Q

Identify: large, mixed echogenicity mass in liver, with necrotic or fibrotic areas due to documented rapid growth

A

liver hemangiosarcoma/angiosarcoma

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27
Q

Identify: multiple, hypoechoic liver lesions, causing inward retraction of hepatic capsule over the lesion

A

epitheloid hemangioendothelioma

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28
Q

age prevalence of hepatoblastoma

A

children under 5 yrs old

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29
Q

most common primary liver malignancy in children

A

hepatoblastoma

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30
Q

Which primary liver malignancy is associated with Beckwith-Wiedemann syndrome?

A

hepatoblastoma

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31
Q

lab values indicative of hepatoblastoma

A

elevated AFP

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32
Q

appearance of hepatoblastoma

A

singular, solid, large, mixed echogenicity, poorly defined walls, calcifications

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33
Q

symptoms of splenic hemangiosarcoma

A

anemia (70% presentation)

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34
Q

common site of metastasis for splenic hemangiosarcoma

A

liver

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35
Q

appearance of splenic hemangiosarcoma

A

variable - similar to splenic hemangioma:

hyperechoic, homogeneous and solid; or complex with cystic degeneration

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36
Q

symptoms of Hodgkin’s lymphoma

A

fever, weight loss, ANEMIA

painless enlarged cervical and clavicular LN’s

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37
Q

age prevalence of Hodgkin’s lymphoma

A

younger

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38
Q

gender prevalence of Hodgkin’s lymphoma

A

male>female

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39
Q

prognosis of Hodgkin’s lymphoma

A

high survival rate

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40
Q

prognosis of non-Hodgkin’s lymphoma

A

poor

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41
Q

age prevalence of non-Hodgkin’s lymphoma

A

older

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42
Q

prevalence of para-aortic lymphadenopathy in Hodgkin’s lymphoma

A

25%

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43
Q

prevalence of para-aortic lymphadenopathy in non-Hodgkin’s lymphoma

A

50%

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44
Q

symptoms of non-Hodgkin’s lymphoma

A

fever, weight loss, NIGHT SWEATS

painless enlarged cervical and clavicular LN’s

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45
Q

common site of metastasis for lymphoma

A

liver, spleen

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46
Q

appearance of splenic metastases caused by lymphoma

A

splenomegaly with solid, anechoic/hypoechoic, homogeneous, lobulated or scalloped mass

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47
Q

5 F’s of likelihood to acquire gallstones

A 
family hx
female
fat
forty's
fertile 
(fair, flatulent)
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48
Q

symptoms of gallbladder carcinoma

A

RUQ pain, fatty food intolerance, occasional nausea and vomitting
jaundice, itchiness

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49
Q

clinical DDx for GB carcinoma, based on symptoms

A

chronic cholecystitis

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50
Q

gender prevalence of GB carcinoma

A

females>males

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51
Q

age prevalence of GB carcinoma

A

60’s-70’s

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52
Q

common site of metastasis for GB carcinoma

A

liver, LN’s

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53
Q

primary adenocarcinoma of the GB

A

GB carcinoma

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54
Q

icterus

A

jaundice

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55
Q

pruritis

A

itchiness

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56
Q

appearance of GB carcinoma

A

polypoid intraluminal lesion, irregular borders, GB wall thickening

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57
Q

normal GB wall dimension

A

under 3 mm

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58
Q

common site of invasion for GB carcinoma

A

adjacent liver tissue and GB fossa

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59
Q

primary adenocarcinoma of the bile ducts

A

cholangiocarcinoma

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60
Q

gender prevalence of cholangiocarcinoma

A

males>females

61
Q

age prevalence of cholangiocarcinoma

A

50’s-60’s

62
Q

risk factors for GB carcinoma

A

gallstones

63
Q

risk factors for cholangiocarcinoma

A

chronic biliary stasis and inflammation, history of choledochal cyst or Caroli’s disease

64
Q

symptoms of cholangiocarcinoma

A

vague - dyspepsia, fatigue
jaundice
pruritis

65
Q

lab values indicative of cholangiocarcinoma

A

elevated serum bilirubin and ALP

66
Q

most common type of cholangiocarcinoma

A

Klatskin’s (hilar region, diffuse intrahepatic duct dilatation)

67
Q

three types of cholangiocarcinoma

A

intrahepatic (isolated ducts)
distal (CBD)
Hilar/Klatskin’s (diffuse, bilobar)

68
Q

appearance of Klatskin’s cholangiocarcinoma

A

diffusely dilated intrahepatic ducts,narrowing of lumen, low level intraluminal echoes, solid mass at porta hepatis, normal CBD

69
Q

location of Klatskin’s cholangiocarcinoma

A

liver hilum/porta hepatis, where CHD is formed by joining of R and L hepatic ducts

70
Q

most common primary pancreatic malignancy

A

primary pancreatic adenocarcinoma

71
Q

lab values indicative of pancreatic adenocarcinoma

A

elevated lipase

72
Q

typical location of pancreatic adenocarcinoma

A

pancreas head

73
Q

age prevalence of pancreatic adenocarcinoma

A

60-80 yrs old

74
Q

risk factors of primary pancreatic adenocarcinoma

A

smoking, alcoholism, diabetes

75
Q

symptoms of primary pancreatic adenocarcinoma

A 
weight loss
PAINLESS jaundice
nausea and vomitting
change in stools
epigastric pain radiating into back
76
Q

What is PAINFUL jaundice indicative of?

A

biliary obstruction

77
Q

What is PAINLESS jaundice indicative of?

A

malignancy

78
Q

appearance of primary pancreatic adenocarcinoma

A

ill-defined, solid, hypoechoic, variable echotexture

79
Q

size of primary pancreatic adenocarcinoma

A

greater than 2 cm

80
Q

Identify: solid mass at porta hepatis, normal CBD, dilated intrehepatic ducts with low level intraluminal echoes and narrowing lumen

A

Klatskin’s cholangiocarcinoma

81
Q

Identify: splenomegaly with solid, anechoic/hypoechoic, homogeneous, lobulated or scalloped mass in spleen, enlarged cervical LN’s, and night sweats vs anemia

A

lymphoma (non-Hodgkin’s vs Hodgkin’s)

82
Q

Identify: polypoid intraluminal GB lesion, irregular borders, GB wall thickening, hx of gallstones

A

primary GB carcinoma

83
Q

Identify: ill-defined, solid, hypoechoic, homo/heterogeneous mass in pancreatic head

A

primary pancreatic adenocarcinoma

84
Q

indirect signs of pancreatic adenocarcinoma

A

double duct sign, Courvoisier’s GB/sign

85
Q

double duct sign

A

both the CBD and pancreatic duct are dilated, likely due to obstruction at the pancreatic head

86
Q

Courvoisier’s sign

A

non-tender, distended, palpable GB due to obstruction caused by malignancy of GB, bile ducts, or pancreatic head (not due to stones)

87
Q

gender prevalence of cystic pancreatic neoplasms

A

women>men

88
Q

age prevalence of cystic pancreatic neoplasms

A

middle aged - older population

89
Q

appearance of macrocystic pancreatic neoplasms

A

large, encapsulated, may be uni- or multilocular

90
Q

macrocystic pancreatic neoplasm, aka

A

pancreatic mucinous cystadenoma

91
Q

pancreatic mucinous cystadenoma, aka

A

macrocystic pancreatic neoplasm

92
Q

size of macrocystic pancreatic neoplasms

A

larger than 2 cm

93
Q

typical location of macrocystic pancreatic neoplasms

A

pancreatic tail

94
Q

name a malignant pancreatic neoplasm that is often found in the tail

A

macrocystic pancreatic neoplasm

95
Q

name a benign pancreatic neoplasm that is often found in the head

A

microcystic pancreatic neoplasm

96
Q

name a malignant pancreatic neoplasm that is often found in the head

A

primary pancreatic adenocarcinoma

97
Q

Identify: large, encapsulated cystic area in the pancreatic tail, may be uni- or multilocular

A

macrocystic pancreatic neoplasm

98
Q

Identify: small, echogenic, well defined cystic area in the pancreatic head

A

microcystic pancreatic neoplasm

99
Q

normal distended GI wall thickness

A

3 mm

100
Q

normal non-distended GI wall thickness

A

5 mm

101
Q

echogenicity of gut signature from inner to outer

A 
collapsed lumen - hyper
mucosa - hypo
submucosa - hyper
muscularis - hypo
serosa - hyper
102
Q

characteristic presentation of benign vs malignant bowel

A

both - hyperemia and lymphadenopathy
benign - long segment involved, symmetric wall thickening, gut signature intact
malignant - short segment involving asymmetric wall thickening, loss of tissue layer differentiation, exophytic masses

103
Q

appearance of thickened bowel

A

target pattern, pseudokidney appearance, loss of tissue layer differentiation, hypoechoic wall with hyperechoic centre

104
Q

What is increased peristalsis indicative of?

A

early stage obstruction and inflammation

105
Q

What is decreased peristalsis indicative of?

A

end stage obstruction, inflammation, and paralytic ileus

106
Q

signs and symptoms of GI neoplasms

A

pain, anemia, anorexia, palpable, blood in stool, internal bleeding

107
Q

most common primary malignant GI neoplasm

A

GI adenocarcinoma

108
Q

gender prevalence of primary GI adenocarcinoma

A

males>females

109
Q

common sites of primary GI adenocarcinoma in the stomach

A

prepyloric, antrum, lesser curvature

110
Q

common sites of primary GI adenocarcinoma in the small bowel

A

ileum

111
Q

Which area of the bowel is associated with developing adenocarcinoma with Crohn’s disease?

A

ileum/small bowel

112
Q

common sites of polypoid GI adenocarcinoma in the colon

A

cecum and ascending colon

113
Q

common sites of annular GI adenocarcinoma in the colon

A

descending and sigmoid colon

114
Q

What presentation of primary GI adenocarcinoma is found commonly found in the cecum and ascending colon?

A

polypoid GI adenocarcinoma

115
Q

What presentation of primary GI adenocarcinoma is found commonly found in the descending and sigmoid colon?

A

annular GI adenocarcinoma

116
Q

appearance of primary GI adenocarcinoma

A

large, hypoechoic, target pattern or pseudokidney due to thickened gut wall

117
Q

most common malignant GI tract neoplasm in children under 10 yrs old

A

GI lymphoma

118
Q

appearance of GI lymphoma

A

hypoechoic solid nodules, target pattern lesion, enlarged mesenteric LN’s

119
Q

renal cell carcinoma, aka

A

hypernephroma

120
Q

hypernephroma, aka

A

renal cell carcinoma

121
Q

most common malignant renal neoplasm in adults

A

renal cell carcinoma

122
Q

symptoms of RCC

A

flank pain, gross hematuria, palpable, weight loss, HTN

123
Q

gender prevalence of RCC

A

men>women

124
Q

age prevalence of RCC

A

50-70 yrs old

125
Q

Which malignant renal neoplasm is associated with Hippel-Lindau disease and Tuberous Sclerosis?

A

renal cell carcinoma

126
Q

Hippel-Lindau disease

A

inherited disease characterized by the formation of multiple tumors (both benign & malignant)

127
Q

common sites of invasion for RCC

A

IVC, renal veins, para-aortic LN’s, contralateral kidney

128
Q

appearance of RCC

A

variable echogenicity, hypoechoic halo, possible calcifications

129
Q

most common malignant renal neoplasm in children

A

nephroblastoma/Wilm’s tumour

130
Q

nephroblastoma, aka

A

Wilm’s tumour

131
Q

Wilm’s tumour, aka

A

nephroblastoma

132
Q

age prevalence of nephroblastoma

A

3-4 yrs

133
Q

symptoms of nephroblastoma

A

fever, hematuria, anemia, HTN, palpable

134
Q

appearance of nephroblastoma

A

large, well defined, solid, unilateral, variable echotexture

135
Q

typical size of presentation for nephroblastoma

A

around 12 cm

136
Q

DDx: large pediatric tumour on kidney

A

primary neuroblastoma of the adrenal gland

137
Q

Identify: variable echogenicity adult renal parenchymal mass with hypoechoic halo, possible calcifications

A

renal cell carcinoma

138
Q

location of TCC

A

sinus of kidney - urinary collecting system (calyces, pelvis, ureters, bladder)

139
Q

location of renal cell carcinoma

A

renal parenchyma

140
Q

gender prevalence of TCC

A

men>women

141
Q

TCC

A

transitional cell carcinoma

142
Q

RCC

A

renal cell carcinoma

143
Q

DDx x 3 for TCC

A

blood clots, fungal balls, sloughed papilla from pyramid apex

144
Q

clinical presentation of renal pelvis TCC

A

painless hematuria

145
Q

clinical presentation of bladder TCC

A

painless hematuria, urinary frequency, dysuria, suprapubic pain

146
Q

appearance of renal pelvis TCC

A

ill-defined, hypoechoic mass

147
Q

appearance of bladder TCC

A

focal, non-mobile mass or thickening

148
Q

location of bladder TCC

A

trigone, lateral or posterior bladder walls

Abdomen & Superficial Structures (7 decks)

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