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Abd / SS 2 > Module 2 : Neoplastic Disease > Flashcards

Module 2 : Neoplastic Disease Flashcards

1
Q

typical US appearance of hemangioma of the liver

atypical US appearance of hemangioma

A

small, usually < 3cm
hyperechoic, homogenous and well defined
no colour flow

heterogenous w/ hypo central area

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2
Q

in which gender is FNH more common

why

A

women

influenced by hormones

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3
Q

describe FNH

A

hyperplastic leison made up of normal liver tissue in an abnormal configuration… next most common after hemangioma

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4
Q

can hemangiomas of the liver increase in size w/ preg or estrogen therapy (HRT)

A

yes

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5
Q

describe a hemangioma of the liver

A

most common benign tumor in the liver, made of many small blood capillaries

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6
Q

how will a hemangioma appear in a fatty liver

A

hypoechoic

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7
Q

US appearance of liver lipoma

A

hyperechoic

very similar to hemangioma

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8
Q

describe a liver adenoma

symptoms?

A

uncommon benign tumor, next most common after FNH

USUALLY asymp.

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9
Q 
general info about benign neoplasms:
symptoms 
lab tests 
appearance 
growth 
vascularity
A 
often asymptomatic
no change in lab tests 
well defined and encapsulated 
slow growing 
hypo or avascular
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10
Q

what 2 things are liver adenomas linked to

A

linked to BCPs and type 1 glycogen storage disease

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11
Q

2 risks associated w/ liver adenomas

A

hemorrhage or infarct due to large size

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12
Q

what is a neoplasm

can they be diffuse or focal

A

abnormal tissue growth, cells proliferating at a fast rate

yes

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13
Q

treatment for FNH

A

conservative, depends on size

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14
Q

what other types of imaging/testing can be used to correlate w/ the finding of a benign liver neoplasm

A 
contrast CT, MRI
RBC cell scintigraphy (nuch med) 
sulphur collloid 
contrast US 
biopsy
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15
Q

how will FNH look on a sulpher colloid nuch med scan

why

A

hot or warm

the kupffer cells will eat up the sulpher colloid

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16
Q

what does type 1 glycogen storage disease cause

another name for it

A

fatty liver and liver failure due to too much glycogen

Von Gierke’s Disease

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17
Q

follow up for hemangiomas of the liver

A

re-scan in 6 month and look for changes

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18
Q

describe an adenoma of the GB

A

the only true neoplasm of the GB, can be pedunculated

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19
Q

Are Desmoid tumors more common in M or W

What age grp

A

W due to C sections

20-40

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20
Q

best way to differentiate b/w FNH and adenoma

A

sulphur colloid… hard to differentiate on US

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21
Q

what does exophitic mean

A

‘sticking out’ of the organ

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22
Q

are most adenoma of the adrenal gland hyper or non functioning

A

non

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23
Q

describe adenomyomatosis

can it be focal or diffuse

A

exaggeration of the RA sinuses and proliferation of the smooth muscle wall of the GB which cause cholesterol crystals to become trapped in the walls

yes

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24
Q

if angiomyolipomas are exophitic, why can they be hard to see

A

blend in w/ renal fat

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25
Q

US appearance of an adenoma of the adrenal gland

A

solid, round

hypo

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26
Q

treatment for liver lipomas

A

conservative

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27
Q

Describe a pheochromocytoma of the adrenal gland

Symptoms

A

Hyperfunctiioning tumour of the medulla

Hypertension
Palpating
Tachycardia
Excessive sweating

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28
Q

are benign neoplasms of the spleen rare or common

A

rare

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29
Q

What lab tests will be evaluated w/ pheochromocytoma

A

Urinary catecholamines

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30
Q

what does ‘myelo’ mean

A

bone marrow or bone forming elements

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31
Q

pheochromocytomas are associated w/ which conditions

A

Tuberous sclerosis

MEN syndrome (multiple endocrine neoplasia… can be benign or malignant)

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32
Q

are myelolipomas of the adrenal gland more common in one gender

A

no

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33
Q

what does the term functioning refer to

A

hormone producing

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34
Q

describe angiomyolipomas (AML) in the kidney

A

arise from renal cortex
made up of blood vessels, muscle and fat

most common benign neoplastic mass of kidneys

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35
Q

Which tumors are the most common tumor of the abdo wall

A

Desmoid tumor

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36
Q

statistically, are most focal areas seen in the GB polpys or adenomas

A

polyps (65%)

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37
Q

How can pheochromocytomas effect the panc

A

Can displace panc tail anteriorly

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38
Q

is US conclusive in diagnosing a cavernous hemangioma in the spleen

why

A

no, due to variable appear.

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39
Q

describe a cavernous hemangioma/hemangioma or the spleen

A

congenital

most common benign neoplasm of the spleen, but not commonly seen

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40
Q

typically, are benign islet cell tumors usually functioning or non functioning

A

functioning… while most malignant ones are non functioning

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41
Q

angiomyolipomas are most common in which gender and age grp

A

women

middle age

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42
Q

US appearance of a myelolipoma of the adrenal gland

A

hyper, can blend in w/ perirenal fat
< 5 cm
propagation speed artifact

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43
Q

US appearance of angiomyolipomas in the kidney

A

hyper, well defined
unilateral usually
low blood flow

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44
Q

what benign liver neoplasm is rare in the liver but common in the body else-where

A

lipoma

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45
Q

how does adenomyomatosis effect the size of the GB wall

A

thickens it… will be >3 mm when distended

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46
Q

how will an adenoma appear on a sulphur colloid scan

A

cold

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47
Q

US appearance of Desmoid tumor

A

Hypo and homo

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48
Q

if larger, what malignancy can angiomyolipomas mimic

A

RCC

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49
Q

describe a hamartoma

US appearance

A

rare neoplasm composed of lymphoid tissue

homo, solid, echogenic

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50
Q

most common type of islet cell tumor….. is it benign or malignant

where is it typically located in the panc

A

insulinoma, benign

body or tail

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51
Q

describe tuberous sclerosis

A

fits and zits - seizures and skin growths

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52
Q

US appearance of FNH

A

‘stealth leison’
< 8 cm
central scar w/ doppler flow centrally

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53
Q

where in the GB is adenomyomatosis most common

A

fundus

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54
Q

another name for angiomyolipoma

A

renal hamartoma

called the hemangioma of the kidney

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55
Q

what is the easiest way to detect FNH when scanning

A

look for abnorm. contour/displaced vessels

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56
Q

is a hamartoma encapsulated

A

no

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57
Q

can polyps and adenomas of the GB be differentiated on US

A

no

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58
Q

when do myelolipomas of the adrenal gland present

A

5th - 6th decade

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59
Q

US appearance of GB adenoma

A

hyperechoic and homo
<10mm
avascular

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60
Q

US appearance of cavernous hemangioma of the spleen

A

variable

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61
Q

can adenomas/oncocytomas mimic RCC

A

yes, need biopsy to differentiate

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62
Q

symptoms/results of hyperfunctioning adenomas of the adrenal gland

A

endocrine abnormalities…

Cushings syndrome - increased cortisol
Conns disease - increased aldosterone

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63
Q

describe a myelolipoma of the adrenal gland

symptoms?

A

rare, non-functioning neoplasm that might arise from the zona fasciculate

can cause pain

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64
Q

what is cholesterolosis/strawberry GB

A

multiple non shadowing masses fixed to the GB wall

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65
Q

describe adenomas/oncocytomas in the kidney

symptoms?

A
  • benign masses that present in the 6th-7t decade of life
  • they are identical, differentiated only by size

possible hematuria, pain

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66
Q

describe islet cell tumors

A

most common tumor of the panc

can be benign or malignant, functioning or non functioning

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67
Q

angiomyolipomas are associated w/ which condition

how will angiomyolipomas present sonographically in these patients

A

tuberous sclerosis

bilateral and multiple angiomyolipomas

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68
Q

describe cholesterolosis in the GB

2 types

A

accumulation of cholestrol in the GB wall

  1. cholesterolosis (strawberry GB)
  2. cholesterol polyps
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69
Q

hemangiomas of the liver are more common in which gender

A

women - 5:1

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70
Q

US appearance of pheochromocytoma

A

Solid, unilateral
Hypo
Homo or hetero
>2cm

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71
Q

what are cholesterol polyps

A

focal form of cholesterolosis

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72
Q

describe a lipoma in the liver

symptoms?

A

very rare

USUALLY asymp.

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73
Q

describe an adenoma of the adrenal gland

A

arise from adrenal cortex
hyperfunctioning or non-functioning
single and unilateral usually

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74
Q

if adenomyomatosis effects the mid part of the GB how will it look

A

hour glass

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75
Q

size difference b/w adenomas and oncocytomas

A

Adeno: < 3 cm
onco: > 3 cm

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76
Q

US appearance of islet cell tumors

A 
solid, solitary
usually hypo (larger can be slightly echogenic) 
variable in size
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77
Q

US appearrance of a liver adenoma

A

variable- usually hyperechoic
8-15 cm
solid, single
central colour w/ doppler

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78
Q

Describe a lipoma of the abdo wall

US appearance

A

Made of fat, mobile and soft on palpation, compressible

Slightly hyper to highly echogenic

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79
Q

US appearance of adenomas/oncocytomas

A

well defined

hypo or iso

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80
Q

in which gender are adenomas/oncocytomas more common

A

males

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81
Q

which benign tumor is equally common in men and women

A

myelolipoma

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82
Q

Describe a Desmoid tumor in the abdo wall

Where is it located

A

Arises from c-tissue (aponeurosis or fascia) often found at a surgical or laparoscopic site

Anterior abdo wall usually

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83
Q

When do pheochromocytomas of the adrenal gland present

Are they more common on the R or L adrenal gland

A

4th - 5th decade of life

R

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84
Q

Us appearance of adenomyomatosis

A

hyperechoic foci in the GB wall w/ comet tail artifact

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85
Q

Are Desmoid tumors associated w/ post parting

A

Yes due to C section

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86
Q

what are adenomyomas in the GB

A

focal, mass like areas of adenomyomatosis

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87
Q

treatment for liver adenoma

A

surgery

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88
Q

Describe the growth of Desmoid tumors

A

Slow, infiltration locally

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89
Q

all masses are asymp. unless otherwise written

encapsulated unless otherwise written

A

/

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90
Q

describe a lymphangioma of the spleen

US appearance

A

rare neoplasm cause by lymphatic malformation

variable
can appear as a cystic lymphangiomyomatosis (multi-loculated cyst)

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91
Q

a GB adenoma < than what size is insignificant

A

<10mm

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92
Q

what are malignant neoplasms

2 different origins

A

cancerous growths

epithelial
connective tissue

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93
Q

what are 3 routes of spread for metastatic cancer

A

blood
lymphatics
direct invasion (cancer is in direct contact w/ another organ, facilitating spread)

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94
Q

HCC is specifically associated w/ which metabolic disorder

A

GSD - glycogen storage disease

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95
Q

another name for HCC

A

hepatoma

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96
Q

the disruption of the production of which protein produced by the liver may cause ascites?

A

albumin - controls osmotic balance

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97
Q

malignant neoplasms of which origin are most common

A

epithelial

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98
Q

risk factors for malignant neoplasms

A

viruses (HPV, Hep B and C)
family Hx
environment
hormones (HRT)

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99
Q

which lab values will be elevated w/ HCC

A

ALP AST ALT

and AFP

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100
Q

describe Hepatocellular carcinoma

what are its 3 forms

A

most common primary tumor of the liver occurring in the 6th decade of life

  1. focal solitary
  2. focal multiple
  3. diffuse infiltration
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101
Q

another name for hemangiosarcoma

A

angiosarcoma

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102
Q

risk factors for HCC

A

alcoholic cirrhosis
Hep B and C
toxic metabolites (chronic exposure to chemicals)
metabolic disorders

103
Q

what % of patients w/ HCC will have increased AFP values

A

70%

104
Q

hemangiosarcomas of the liver are associated w/ which risk factors

A

arsenic
thorotrast (old xray contrast)
PVC exposure (polyvinyl chloride)

105
Q

is weight loss in older patients always worrisome

A

yes

106
Q

list some US signs that would be suspicious of malignancy

A 
hypoechoic halo
hypo, solid liver mass 
multiple liver masses 
high velocity signs/arterial waveform in a mass 
hypervascular 
lymphadenopathy
107
Q

describe an epitheloid hemangioendothelioma of the liver

US appearance

A

rare, malignant, vascular tumor

multiple hypo masses
you will see an indentation of the hepatic capsule that is located directly over the lesion

108
Q

describe lymphoma in general terms

A

primary malignant neoplasm of the lymphatic syst

can be nodal or extranodal (anywhere in lymph tissue)

109
Q

is HCC more common in W or M

A

Men

110
Q

what does the term ‘blast’ refer to

A

germ cells

111
Q

hepatoblastomas are associated w/ which syndrome

A

Beckwith-Wiedermann syndrome - over growth syndrome

112
Q

US appearance of Hemangiosarcoma

A

large

mixed echogenicity

113
Q

name for malignant neoplasms that have epithelial origin

A

carcinoma

or more commonly : adenocarcinoma

114
Q

symptoms of hodgkin’s lymphoma

A

fever, weight loss, anemia
painless enlargement of lymph nodes in clavicle and neck area
para-AO lymphadenopathy

115
Q

describe a hepatoblastoma

what age grp does it effect

A

most common primary liver malignancy in children
often poor prognosis

< 5 yrs

116
Q

3 benign abnormalities that cant be distinguished from the hyperechoic presentation of HCC

A

hemangioma
adenoma
lipoma

117
Q

2 types of lymphoma

A

hodgkin’s

non-hodgkin’s

118
Q

describe non-hodgkin’s lymphoma

which age group does it more commonly effect

A

type of lymphoma arising from lymphoid tissue, specifically T and B cells

typically effects a older age grp (65-74 yrs)

119
Q

US appearance of hodgkin’s and non-hodgkin’s

A
  • anechoic, hypo, solid, homo masses seen anterior and posterior to the AO/IVC, may be perceived as poor transmission
  • lobulated or scalloped
  • splenomagaly
  • hydro - nodes compressing ureters
  • organ and vessel displacement
120
Q

w/ HCC, is portal or hepatic vein invasion more common

A

portal

121
Q

which risk factor of HCC is the most common cause of the disease in the west

A

alcoholic cirrhosis

122
Q

symptoms of non-hodgkin’s lymphoma

A

fever, weight loss, night sweats
painless enlargement of lymph nodes in neck area or axillary
para-AO lymphadenopathy
mets to liver and spleen

123
Q

hemangiosarcomas of the spleen are associated w/ which condition

A

anemia (70%)

124
Q

US appearance of HCC

A

often hypo w/ an anechoic halo
<5 cm
high velocity signal w/ doppler
portal/hepatic venous invasion

125
Q

name for malignant neoplasms that have connective tissue origin

A

sarcoma

126
Q

what % of people w/ hodgkin’s lymphoma have para-AO lymphadenopathy

A

25%

127
Q

what % of people w/ non-hodgkin’s lymphoma have para-AO lymphadenopathy

A

50%

128
Q

US appearance of a hemangiosarcoma of the spleen

A

similar to cavernous hemangioma in the spleen

129
Q

Another term for GB carcinoma

Is it associated w/ stones

A

Adenocarcinoma

Yes

130
Q

does hodgkin’s lymphoma effect M or W more

A

M

131
Q

describe a hemangiosarcoma of the spleen

where does it often spread

A

rare primary tumor of spleen, often there is mets to the liver

132
Q

Describe a cholangiocarcinoma

What age does it usually occur

A

a slow growing adenocarcinoma of the bile ducts

50-60 yrs

133
Q

are conditions w/ painless presentations usually more of less worrisome

A

more

134
Q

US appearance of adenocarcinoma of the GB

A
  • Polyp w/ irregular borders or mass
  • Thickening of GB wall (focal or diffuse)
  • maybe be invading the liver
135
Q

What does puritus mean

A

Itchy skin

136
Q

symptoms of HCC

A

RUQ pain
weight loss
ascites
hepatomegally (= 15.5cm is norm, 17cm upper limit)

137
Q

Risk factors for cholangiocarcinoma

A
  • Chronic biliary stasis and inflammation

- Patient Hx of choledochal cyst or caroli’s

138
Q

proven causes of malignant neoplasms

A

exposure to carcinogens and radiation

139
Q

What lab value will be elevated with adenocarcinoma of the panc

A

Lipase

140
Q

Which type of cholangiocarcinoma is most common

A

Hilar / Klatkins

141
Q

Clinical presentation of adenocarcinoma of the panc

A

Painless jaundice
Nausea and vomiting
Changes in stool due to obstruction (bile not entering duodenum)

142
Q

Direct signs of adenocarcinoma of the panc on US

A

> 2cm
Hypo
variable echoexture

143
Q

Describe Hilar / Klatkins cholangiocarcinoma

Where do it often occur (location)

A

Most common cholangiocarcinoma

At the bifurcation of R and L CHD

144
Q

What’s the prognosis of adenocarcinoma of the panc

A

Poor

145
Q

2 types of cystic neoplasms of the panc

A
  1. Microscopic (serous cystadenoma)

2. Macroscopic (mucinous cystadenoma)

146
Q

US appearance of Hilar / Klatkins cholangiocarcinoma

A

*CBD is norm
*Dilated intrahepatic ducts
solid mass at liver hilum
Bulging of ducts

147
Q

US appearance of a hepatoblastoma

A

single, solid, large

mixed echogenicity, poorly defined walls, calcium deposits

148
Q

Describe an adenocarcinoma of the panc

Risk factors for panc adenocarcinoma

A

Typically effects panc head
Most common malignancy of the panc

Smoking, alcohol and diabetes

149
Q

Where is it common for adenocarcinoma of the GB to spread

A

Lymph nodes and liver

150
Q

describe a hemangiosarcoma of the liver

what age grp does it typically effect

A

rare aggressive cancer w/ rapid spread

60-80yrs

151
Q

what are organ and vessel displacement is specific to hodgkin’s and non-hodgkin’s

A

floating AO - Ao pushed anteriorly
sandwich - SMA displaced anteriorly
silhouette/mentle sign - enlarged nodes surrounding AO and IVC

152
Q

In what age group does a cystic neoplasm of the panc usually occur

A

Middle age to older age group

153
Q

In what age group does adenocarcinoma of the panc usually occur

A

60-80 years

154
Q

US appearance of Macroscopic (mucinous cytadenoma)

A

Larger cystic areas (>2cm)

Unilocular or multiocular

155
Q

whats a norm wall thickness of the GI tract when distended and non distended

A

distended: 3 mm

non distended: 5 mm

156
Q

what are the advantages of CT and angiography over US

A

better at assessing vascularity and extent/size

157
Q

causes of increased peristalsis

A

obstrution and inflammation

158
Q

Describe a Microscopic (serous cytadenoma) of the panc

Where does it often occur in the panc

A

Benign, occurs more often in the panc head

159
Q

Clinical presentation of cholangiocarcinoma

Which lab values will be increased

A

Vague/insidious
Jaundice/pruritis
Elevated serum bilirubin and ALP

160
Q

3 forms of cholangiocarcinom

A

Intrahepatic
Distal (region of CBD)
Hilar or Klatskins

161
Q

clinical presentation of GI primary malignant neoplasm

A

pain
anemia
palpable mass
blood in stool

162
Q

is an adenocarcinoma of the GI tract occurs in the sm. bowel, which area will likely be effected

increased risk of this w/ which disease

A

ileum

crohns

163
Q

can lymphadenopathy and hyperemia be seen in both benign and malignant conditions of the GI

A

yes

164
Q

Signs and symptoms of adenocarcinoma of the GB

A

Similar to chronic cholecystitis (RUQ pain and intolerance to fatty foods)

Jaundice and pruritus in late stages

165
Q

US pattern of thickened gut

A

target appearance of pseudo kidney

hypo rim (represents thick gut wall) w/ hyper center (residual lumen)

166
Q

When does adenocarcinoma of the GB usually present

A

6-7th decade of life

167
Q

is adenocarcinoma of the colon common

2 presentations in the colon

A

yes

polypoid (more often in cecum and AC)
or
annular (descending and sigmoid)

168
Q

US appearance of adenocarcinoma of the GI

what else should you look for in the abdoment

A

large, hypo mass
thick gut wall w/ characteristic signs

look for nodes and mets

169
Q

describe lymphoma of the GI tract

What age group does it effect

A

can be primary or mets…. if primary will be non-hodgkins

most common GI tumor in children <10

170
Q

Indirect signs of adenocarcinoma of the panc on US

A

Dilated panc duct, and bile ducts
Double duct sign
Dilated GB (courvoisier’s GB)

171
Q

what lab value will be elevated w/ a hepatoblastoma

A

AFP

172
Q

will obstructed and inflamed bowel be compressible

A

no

173
Q

What is a courvoisier’s GB

A

Dilated GB that creates palpable mass

174
Q

what is the most common malignant tumor of GI tract

A

adenocarcinoma

175
Q

describe hodgkin’s lymphoma
prognosis?

which age group does it more commonly effect

A

type of lymphoma that typically effects a younger age grp (15-40 yrs)… spread to other organs but good prognosis

176
Q

US appearance of lymphoma of the GI tract

A

hypo, solid nodules
target lesion
involves mesenteric nodes

177
Q

what is hippel-lindau

A

inherited disease where people form both benign and malignant tumors in their body

178
Q

what other areas of the body should you check w/ RCC

A 
IVC for tumor invasion (causes leg edema)
renal veins 
para AO lymph nodes 
contralateral kidney 
testes for varicose veins
179
Q

clinical presentation of nephroblastoma

A 
fever
hematuria 
hypertension 
palpable mass 
anemia
180
Q

how will the GI wall look w/ benign conditions that cause thickening

A

long segment involved
symmetrical thickening
individual layers are still seen

181
Q

the term ‘blast’ often refers to what

A

germ cells….. so these conditions are often more common in children

182
Q

what other pediatric tumor could a nephroblastoma be confused with and why

A

neuroblastoma

183
Q

Describe a Macroscopic (mucinous cytadenoma) of the panc

A

Uncommon

Malignant, often in a panc tail

184
Q

all primary malignant tumors of the urinary tract are more common in which gender

A

men

185
Q

another name for nephroblastoma

A

Wilm’s tumor

186
Q

another name for RCC

A

hypernephroma

187
Q

RCC is associated w/ which 2 conditions

A

tuberous sclerosis

hippel-lindau

188
Q

clinical presentation of TCC

A

gross or microscopic hematuria

189
Q

2 procedure need to diagnose TCC of the bladder

A

cystoscopy and biopsy

190
Q

describe a transitional cell carcinoma (TCC) of the kidney

A

arises from the epithelial lining of the collecting system (eg calyces, renal pelvis, ureters, bladder)

191
Q

does the annular form of adenocarcinoma in the colon cause obstruction

A

yes

192
Q

describe squamous cell carcinoma (bladder)

its associated w/ which conditions

A

rare, aggressive bladder cancer w/ distal mets

chronic UTIS, stones and strictures

193
Q

how will the GI wall look w/ malignant conditions that cause thickening

A

short segment involved
asymmetrical thickening
destruction of layers

194
Q

nephroblastoma are associated w/ which conditions

A

Beckwidth wiedemann

195
Q

US appearance of TCC in the renal sinus

A

ill defined, hypo mass

196
Q

clinical presentation and US appearance of squamous cell carcinoma (bladder)

A

same as TCC

197
Q

symptoms for TCC of the bladder

A

painless hematuria
frequency
dyuria
suprapubic pain

198
Q

US appearance of TCC in the ureters

A

hydro above the solid mass

199
Q

describe an adenocarcinoma of the prostate

which zone does it commonly effect

A

most commonly diagnosed cancer in men

peripheral zone, then spreads towards the capsule

200
Q

describe a nephroblastoma

what age does it present

A

most common malignant renal tumor in children

3-4 yrs

201
Q

US appearance of the Microscopic (serous cytadenoma)

A

Many small cysts <2 cm

Can appear solid and echogenic due to multiple cysts

202
Q

US appearance of nephroblastoma

A

large, well defined, solid, unilateral
variable echotexture
lymphadenopathy and mets

203
Q

describe a cortical cancer of the adrenal

A

rare, often an adenoma, in cortical region

can be hyperfunctioning or nonfunctioning

204
Q

US appearance of adenocarcinoma of the prostate

A

if sm: hypo

if lrg: variable

prostate losses smooth contour

205
Q

US appearance of TCC in the bladder

which areas does it commonly effect

A

non-mobile mass or thickened wall (blood clot would be mobile)

commonly effect the trigone, lateral and posterior walls

206
Q

signs and symptoms of adenocarcinoma of the prostate

A 
asymp.
may have bone pain 
weakness 
weight loss 
PSA elevated
207
Q

describe a neuroblastoma

what age grp does it effect

A

highly malignant tumor arising from adrenal medulla

found in children 4-5 yrs

208
Q

treatment for adenocarcinoma of the prostate

A

monitor
cryotherapy
radiation (brachytherapy or external beam)
radical prostatectomy (gold standard, risk for nerve damage)

209
Q

clinical presentation of a neuroblastoma

A

palpable mass
weight loss
failure to thrive
very irritable

210
Q

describe RCC

what age grp does it most often effect

A

an adenocarcinoma that is the most common malignant renal tumor in adults

50-70

211
Q

3 DDX for TCC in the renal pelvis

A

blood clot
fungal balls
sloughed papilla (point of pyramid)

212
Q

US appearance of a neuroblastoma

A

solid, hetero, poorly defined
calcifications
renal displacement
mets to liver and around great vessels

213
Q

a mesothelioma of the peritoneum is associated w/ exposure to what materials

what age group and gender does it effect

A

asbestos

middle aged men

214
Q

US appearance of cortical cancer of the adrenal

A

well define, solid mass
variable echogenicity/echotexture
regional and nodal mets

215
Q

4 clinical presentations of excessive hormone production by the adrenals

A

cushings syndrome (+ cortisol)
Conns disease (+ aldosterone)
viralization/feminization
precocious puberty

216
Q

are cortical cancers usually hyperfunctioning or nonfunctioning in males and females

A

M: non-func.
F: function.

217
Q

US appearance of mesothelioma of the peritoneum

A

omental caking/thickening
peritoneal thickeneing
ascites

218
Q

lymphoma of the peritoneum is associate w/ which condition

A

AIDS

219
Q

are malignant neoplasms of the peritoneum rare

A

yes

220
Q

US appearance of RCC

A

variable echogenicity

hypo rim

221
Q

echotexture tendencies of hyper and non-functioning cortical cancers of the adrenal

A

hyper: homo
non: hetero

222
Q

at what age does adenocarcinoma of the prostate usually occur

risk factors

A

> 50

age, fatty diet, family Hx

223
Q

Risk factors for GB carcinoma (5 F’s)

A 
Female
Fat
40
Fertile
Family Hx
224
Q

clinical presentation of RCC

A 
flank pain
gross hematuria 
palpable mass 
hypertension 
weight loss
225
Q

4 steps for evaluating adenocarcinoma of the prostate

A

DRE, PSA, TRUS, biopsy

226
Q

describe lymphoma of the peritoneum

US appearance

A

non-hodgkin’s type

hypo mass along the peritoneum

227
Q

most common sites for mets (BALL)

A

bone
adrenals
liver
lung

228
Q

are primary or secondary cancers the most common malignant tumor(s) of the liver

A

secondary

229
Q

what lab values will be increase w/ liver mets

A

LFTs:
Alk phos
AST
ALT

230
Q

Us appearance of GI mets

A

large, well defined, hypo mass w/ ring down

231
Q

what is peritoneal carcinomatosis

US appearance

A

diffuse metastatic spread to peritoneum

omental caking/thickening
hypo nodules or masses
ascites
mesenteric thickening or lymphadenopathy

232
Q

which cancers usually mets to the adrenals

A

lung
breast
melanoma

233
Q

is mets to the GB usually associated w/ gallstones

A

no (where as primary cancer of the GB are)

234
Q

US appearance of metastatic lymphoma to the kidney

A
  • non-specific renal enlargement and diffusely hypo kidney
  • look for vessel/organ displacement due to enlarged nodes

appearance of other types of kidney mets are variable

235
Q

which organ is the 4th most common site of mets

A

adrenal

know for registry

236
Q

typical US appearance of panc mets

A

small hypo mass

237
Q

is adrenal mets usually bilateral

A

yes

238
Q

is lymphadenopathy often seen w/ mets

A

yes

239
Q

Acronym for all malignant and benign neoplasms that are more common in women

A

FAD & HCG

F - FNH
A - AML & adenoma
D - Desmoid

H - Hemangioma
C - Cystic neoplasms of the panc
G - GB carcinoma

240
Q

signs and symp. of liver mets

A

hepatomegally
jaundice
pain
anorexia/nutritional wasting and muscle deterioration

241
Q

what is pseudomyxoma peritonei

A

gelatinous ascites that almost always originates from perforated appendiceal epithelial tumor

242
Q

US appearance of pseudomyxoma peritonei

A

complex ascites

non mobile bowel loops pushed centrally and posteriorly, creating the ‘starburst appearance’

243
Q

mets to which organs/areas of the body are rare

A

spleen
panc
GI tract
bladder

244
Q

is mets to the kidney common

from which organs?

A

yes

lung, breast, other kidney

245
Q

mets to the abdo wall typically occurs from which primaries

Us appearance

A

melanoma

hypo mass w/ posterior enhancement (dont confuse w/ a cyst)

246
Q

does liver mets usually produce symptoms

A

no

247
Q

Acronym for all malignant and benign neoplasms that are more common in men

A

MAAC HALL

M - Mesothelioma
A - Adenoma of the GI
A - Adenoma of the panc
C - Cholangiocarcinoma

H - HCC
A - Adenoma/oncocytoma of the kidney
L - Lymphoma (Hodgkins)
L - Lymphoma of the GI

All primary malignancies of the peritoneum (mesotheiloma and lyphoma of GI)
and ALL primary malignancies of the urinary tract (not included here)

248
Q

what is needed to determine the origin of mets tumors

A

biopsy

249
Q

Acronym for all malignant and benign neoplasms that can have a variable US appearance

A

H[AL]L MARC

H - hemangioma of the spleen/hemangiosarcoma of the spleen
AL - abdo wall lipoma (varying degrees of echogenic)
L - lymphangioma of the spleen

M - mets to the liver
A - adenoma of the liver (often hyper but varies)
R - RCC (vairable ecogenicity)
C - cortical cancer

250
Q

prognosis for pseudomyxoma peritonei

A

variable

251
Q

most common site for mets to the GI to occur

A

stomach, then Sm bowel, the colon

252
Q

suggestice US appearance for liver mets

A

multiple lesions

hypoechoic halo

253
Q

mets to the retroperitoneum typically occurs from which primaries

A

testicular

pelvic tumors

Abd / SS 2 (7 decks)

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