Pathology Descriptions Flashcards by Paige Everding

Dilated aorta >3cm
Fusiform or saccular

AAA

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Asymptomatic until rupture
Abdo/back pain
Pulsatile abdominal mass
Hypotension
Syncope

↓Haematocrit
↓Haemoglobin

AAA

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Saccular outpouching, localised and round/oval adjacent to artery
Hypoechoic/anechoic centre
Surrounding echogenic thrombus
Yin/Yang sign (Doppler)

Pseudoaneurysm

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Localised pain/swelling
Palpable, pulsatile mass
Skin discolouration/warmth
↑WBC
↑CRP
↓Haematocrit/Haemoglobin

Pseudoaneurysm

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Separates true/false lumen
Mobile, echogeni c line within aorta
May extend into branch arteries

Dissection aneurysm

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Sudden, severe chest/back pain
Signs of ischaemia
Syncope/shock
↓Haematocrit
↑CRP

Dissection aneurysm

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Aneurysmal dilation with thickened adventitia
Hypoechoic surrounding fibrosis of tissue around aorta
Sparing of posterior wall

Backache
Leg oedema

Inflammatory AAA

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Pulsatile mass
Normal appearance of aorta
Large pelvic mass/mass elsewhere

PHx FIbroid uterus, para-aortic lymph nodes, retroperitoneal tumour

Pseudo-pulsatile abdominal mass

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A congestive liver disease caused by wide array of conditions compromising HV outflow: thrombotic, non thrombotic

Budd-chiari syndrome

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Reduced flow in hepatic veins, Echogenic thrombus in hepatic veins or IVC
Heterogenous/hypoechoic liver parenchyma
Anechoic fluid collection in abdomen
Dilated IVC

Budd-chiari syndrome

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RUQ pain
Jaundice
Ascites
Hepatomegaly
Abnormal LFTs
IVC involvement = lower leg oedema

Budd-chiari syndrome

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Dilated portal, spleen & mesenteric veins (PV >15mm)
Patent paraumbilical veins
Varices
Splenomegaly
Ascites (anechoic abdo fluid)
Atrophied live w/irregular surface

Portal venous hypertension

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Causes of Pre-hepatic, post hepatic or hepatic portal venous hypertension

Congenital portal atresia, PV thrombosis, phlebitis of the PV, trauma of thrombosed portocaval shunt

Pre-hepatic

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Causes of pre-hepatic, post-hepatic or hepatic portal venous hypertension?

Budd-Chiari syndrome, constrictive pericarditis, tricuspid valve incompetence

Post-hepatic

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Causes of pre-hepatic, post-hepatic or hepatic portal venous hypertension

cirrhosis (alcoholic most frequent), chronic active hepatitis, parasitic diseases (schistosomiasis)

Hepatic

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Marked ascites
Arterio-venous shunting
Haemorrhoids
Hypersplenism:
- Moderate anaemia, neutropaenia, thrombocytopaenia

Portal venous hypertension

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Consequence of portal vein thrombosis
Ascites
Jaundice
Fatigue
WL/LOA
Abdo pain

Cavernous transformation of portal vein

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Doppler: Hepatopetal, continus flow, low velocity
Extrahepatic PV not visualised
High level echoes in porta hepatis

Cavernous transformation of portal vein

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Caused by biliary disease, alcohol abuse, trauma, ulcers

S&S:
Abdo pain
N,V,F
PHx gallstones, alcoholism
Jaundice, malabsorption
↑enzymes & leukocytes
↑serum amylase
↑urine amylase
↑serum lipase

Pancreatitis

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Pancreas parencyhma:
Hyperechoic, homogenous, enlarged
Oedematous
Irregular borders
Peripancreatic fluid

Acute pancreatitis

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Pancreas parenchyma:
Hyperechoic, heterogenous, atrophied
Irregular borders
Double duct sign - dilated pancreatic duct & dilated CBD
Calcifications in duct/ducts
Possible peripancreatic fluid

Chronic pancreatitis

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PHx recurrent attacks of acute pancreatitis
PHx chronic alcoholism or Biliary disease

Pt may have:
Pseudocysts, ascites
Dilated CBD
Thrombosis of splenic vein, extending into portal vein

Chronic pancreatitis

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A collection of fluid in the pancreas that arises from the loculation of inflammatory processes, necrosis, or haemorrhage
4-6 wks after onset of pancreatitis

Pancreatic pseudocyst

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Well-defined cystic lesion adjacent to panc
Round/oval
Internal echoes may be seen due to debris

N,V,LOA
WL
Diarrhoea, fever
Tender abdo mass
Jaundice

Pancreatic pseudocyst

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A cancer that develops in the lining or inner surface of the pancreas and usually has secretory properties

Pancreatic adenocarcinoma

Abdo/back pain Onset of NIDDM/existing diabetes more difficult to control LOA/WL/N/V Diarrhoea/constipation Jaundice, enlarged GB Itchy skin

Pancreatic adenocarcinoma

Heterogenous, hypoechoic solid mass May have cystic component Double duct sign if mass in panc. head

Pancreatic adenocarcinoma

Forms in cells that make gastrin ↑gastrin & stomach acid Forms in head of panc, sometimes small intestines Most are malignant Recurrent stomach ulcers Abdo/back pain Reflux Diarrhoea

Gastrinoma

Forms in cells that make insulin Slow growing, rarely spreads Forms in head, body or tail of panc Usually benign

Insulinoma

Hypoglycaemia w/signs: blurred vision, headache, lightheaded Tired, weak, shaky, nervous Irritable, sweaty, confused Hungry, fast HR

Insulinoma

Panc duct anomaly: Primary duct Extends the entire of the gland

Duct of Wirsung

Panc duct anomaly: Secondary duct Drains upper anterior head

Duct of Santorini

PHx obesity & aging PHX pancreatitis, ETOH++, liver disease Dyslipidaemia & hyperglycamia = non-alcoholic version of this

Fatty pancreas

Diffuse hyperechoic pancreas parenchyma Can be enlarged More attenuating

Fatty pancreas

Acute RUQ pain Fever Leukocytosis ↑serum bilirubin ↑ALP Thickened GB wall (<3mm) Distended GB lumen (<4cm) Echogenic calculi +ve Murphy's sign Increased vasc in GB wall Pericholecystic fluid collection Impacted stone in GB neck, Hartmann's puch, cystic duct

Acute cholecystitis or without ↑serum, ALP & calculi: Acute acalculous cholecystitis

PHx repeated acute cholecystitis RUQ pain Thickened GB wall GB scarring Atrophied Lack/minimal pericholecystic fluid

Chronic cholecystitis

Air in wall/lumen of GB, tissue adjacent or in biliary ducts WES sign if air within GB

Emphysematous cholecystitis

Thickened GB wall, de-lamination ↓vascularity Irregular GB mucosal layer outline Gas within GB Possible absence of calculi Large pericholecystic collection

Gangrenous cholecystitis

When bile flow ceases or reduces significantly, caused by some of the following: Acute hepatitis Alcoholic liver disease Cirrhosis (Hep B, C) Pancreatic adenocarcinoma Pancreatitis

Cholestasis

Jaundice Dark urine Light-coloured stools Itching Abdo pain/LOA/V/F Not specifically visible on U/S

Cholestasis

PHx gallstones & inflammation of GB S&S: same as most GB pathology Thickened wall Irregular shape/margins Hypoechoic, heterogenous Invasion of adjacent structures

GB adenocarcinoma

>40 yrs old (most pts) Formation of Rokitansky-Aschoff sinuses Comet tail artefact

Adenomyomatosis

Calculi within bile duct Primary: within bile ducts Secondary: moved into biliary tree from GB

Choledocholithiasis

Inflammation of bile ducts/biliary tree Most commonly frm calculi, can be from stricture or malignancy Segmental narrowing & dilation of bile duct Thickened biliary duct wall

Cholangitis

Bile duct cancer PHx choledochal cyst, chronic liver disease Abdo pain Jaundice WL/F Itching

Cholangiocarcinoma

Dilation of intra & extrahepatic bile ducts Hypoechoic, heterogenous Bile duct wall thickening/mass

Cholangiocarcinoma

Caused by round worm Come through sphincter of Oddi into biliary tree Echogenic worm like structures in GB

Ascariasis

Fatty liver disease associated with dyslipidaemia

Non-Alcoholic steatosis

Fatty liver disease that can lead to hepatomegaly, hepatitis, cirrhosis

Alcohol-related steatosis

Mild: Minimal diffuse increase in hepatic echogenicity Moderate: increased echogenicity, slightly impaired visualisation, slightly grainy Severe: Significant increase in echogenicity of liver, decreased penetration, very grainy

Steatosis

Fatigue, N/V/F Abdo pain Dark urine Joint pain Liver texture may appear normal PV more prominent than usual Slightly hypoechoic liver parenchyma Attenuation Hepatospelnomegaly GB wall thickened

Acute Hepatitis

May be asymptomatic Coarse/echogenic due to fibrosis PV walls less discrete Liver not enlarged Soft shadowing due to fibrosis Changes to liver contour

Chronic hepatitis

Permanent scarring of the liver where normal liver tissue is replaced by scar tissue

Cirrhosis

Hepatomegaly, jaundice, ascites N/WL/F Anorexia Dark urine Fatigue Varicosities Micronodular, macronodular or mixed Irregular liver contour enlarged caudate lobe splenomegaly

Cirrhosis

Inner layer of connective tissue layer over the liver and surrounding the portal triad within the liver Can be cause of pain with hepatomegaly

Glisson's capsule

Present in the liver Benign Anechoic fluid Well-circumscribed Thin-walled

Simple liver cysts

Genetic disease Most often associated with autosomal dominant polycystic kidney disease Multiple cysts throughout liver

Polycystic liver disease

Symptoms: Abdo pain Post-prandial epigastric pain/discomfort Sono app: Often multiloculated Well-defined Anechoic Septations DDx: Simple cysts Cystadenocarcinoma Focal nodular hyperplasia

Cystadenoma

Sympt: Maybe asymptomatic Jaundice WL/P/ Distension Ascites Dyspnoea Sono app: Multiloculated Intracystic solid areas Septations Grows from biliary epithelium DDx: cystadenoma pseudocyst Focal nodular hyperplasia Hepatic cysts

Cystadenocarcinoma

Symp: RUQ pain Chest pain F/chills/night sweats N/V/LOA WL Sono app: Poorly demarcated Variable appearance/echogenicity Gas may be present

Hepatic abscess

Most prevalent tumour of the liver Benign Most often asymptomatic Larger may cause pain/discomfort Sono app: well-circumscribed, echogenic solid lesions Mostly no vascularity

Haemangioma

Benign Often asymptomatic Arises from pre-existing arteriovenous malformation in liver Sono app: Well-circumscribed Isoechoic/hypoechoic Solid lesion Hypervascular

Focal nodular hyperplasia

Rare, presents in adult females Mainly found in kidneys, can present in liver Blood, muscle, fat Sono app: Mostly hyperechoic & homogenous Can be heterogenous

Angiomyolipoma (AML)

Well-circumscribed Echogenic solid lesion Posterior enhancement Consists of fat & blood

Lipoma

PHx: Sarcoidosis Tuberculosis Neoplastic disease Primary biliary cholangitis or drug induced Sono app: Highly echogenic solid focus Posterior shadowing Irregularly shaped if larger

Granuloma

PHx chronic liver disease Symp: RUQ pain, lump LOA/WL N/F/V Jaundice Sono app: Densely echogenic Diffuse Mixture of densely echogenic or diffuse Can be solitary, multiple nodules or diffuse infiltrative masses

Hepatocellular carcinoma (HCC)

Childhood tumour up to 5 yrs Most begin in right lobe of liver Symp: RUQ pain, lump LOA/WL N/F/V Jaundice Sono app: Hyperechoic, hetero Calcifications Vascular Solid

Hepatoblastoma

Symp: Weakness/poor health LOA/WL Fever Fatigue/bloating/itching Leg oedema Jaundice Sono app: Hypoechoic, hetero Variable echogenicity Target lesions Multiple

Liver Metastases

Most common metastases from colon or rectal cancer Less commonly from breast, oesophageal, stomach, panc, lung, kidney, skin

Liver metastasis

Symp: Often non-specific Haematuria Flank pain Palpable mass Sono app: Mostly isoechoic but can be hyperechoic

Renal cell carcinoma

Rare type of kidney cancer, most common bladder/lower UT cancer Symp: Back pain Haematuria Frequency Sono app: Solid lesion Hypoechoic Originate within renal pelvis or calyx

Transitional Cell Carcinoma (TCC)

Most common childhood cancer Affects 3-4 yrs old, less common after 5 Symp: Constipation abdo pain/swelling N/V/F/LOA Sono app: Large solitary, solid mass Echogenic May contain cystic areas/multiloculated Can be present in utero

Wilm's Tumour (nephroblastoma)

Most common metastasises from carcinomas (lung, colorectal, ENT, breast, soft tissue, thyroid) Symp: Flank pain, haematuria WL

Renal metastases

Vesicoureteric reflux due to blockage of urine flow down ureter

Hydronephrosis

Sono app: Dilated ureter/s Depending on grade: 2. Full pelvis, major calyces dilated 3. Uniformly dilated minor calyces, parenchyma spared 4. Parenchyma compromise

Hydronephrosis

Symp: Severe pain Sono app: Very echogenic calculi within bladder Posterior shadowing

Urolithiasis

Increased calcium levels in the kidney Caused by hypercalcaemia due to hyperparathyroidism, medications, sarcoidosis

Nephrocalcinosis

Sono app: Calcification in medullary pyramids Posterior shadowing depending on calcifications

Nephrocalcinosis

Urine backs up into kidney causing swelling Sono app: Unilateral or bilateral Hydronephrosis Changes to renal arterial Haemodynamics Thinned parenchyma (long term)

Obstructive nephropathy

Type of blood cancer: bone marrow over-produces RBCs Enlarged spleen Hepatomegaly, ascites, DVT Splenic infarctions & thromboses common

Polycythaemia vera

Pathology Descriptions Flashcards

(81 cards)