Ardms Abdomen/ Liver Pathology

Front 1

Fatty infiltration

Back 1

Increased lipid accumulation in the hepatocytes and results from significant injury to the liver or a systemic disorder leading to impaired or excessive metabolism of fat. Benign, reversible.
Common causes: alcoholic liver disease, Diabetes mellitus, obesity, severe hepatitis, steroids.

Front 2

Fatty infiltration, ultrasound findings

Back 2

Increased echogonicity, enlargement, portal vein difficult to visualize.

Front 3

Hepatitis

Back 3

Inflammatory and infectious disease of the liver.

Front 4

Hepatitis A

Back 4

Spread by the fecal contamination.

Front 5

Hepatitis B

Back 5

Caused by type B virus, which exists in the blodstream and can be spred by transfusions of infected blood or plasma or through the use of contaminated needles.
also found in body fluids such as saliva and semen and can be spread by sexual contact.

Front 6

Symptoms of hepatitis

Back 6

Patient presents with flulike and gastrointestinal symptoms, includingloss of appetite, nausea, vomiting and fatigue, possible jaundice

Front 7

Labs with hepatitis

Back 7

Increased AST, ALT(falls rapidly after several days), and bilirubin. Leukopenia(abnormal decrease in white blood corpuscles) is present.

Front 8

Acute hepatitis

Back 8

Changes seen with acute hepatitis:
1)liver cell injury, swelling of the hepatocytes and hepatocyte degeneration, which may lead to cell necrosis
2)reticuloendothelial and lymphocytic response with Kupffer calls enlarging
3)regeneration

Front 9

Hepatitis ultrasound findings

Back 9

Echo normal or decreased, hepatosplenomegaly, thickened GB wall.

Front 10

Cirrhosis

Back 10

Chronic degenerative sidease of the liver in which lobes are covered with fibrous tissue.
liver cell failure and portal hypertention as the end stage.
Caused by chronic alcohol abuse, nutritional deprivationor hepatitis or other infection.

Front 11

Cirrhosis symptoms

Back 11

Nausea, flatulence, anorexia, weight loss, ascites, light-colored stools, weakness, abd pain, varicosities and spider angiomas.

Front 12

Cirrhosis ultrasound findings

Back 12

Coarsening of the liver parenchymasecondary to fibrosis and nodularity. increased attenuation with decreased vascuular markings. Hepatosplenomegalywith ascites.
Chronic corrhosis may show nodularity of the liver edge.

Front 13

Glycogen storage disease

Back 13

Most common type 1 or Von Gierke's,
Form of glycogen storage disease in whoch abnormally large amounts of glycogen are deposited in the liver and the kidneys.
Sono: hepatomegaly, increased echogenicity, increased attenuation. Associated with hepatic adenomas, FNH.

Front 14

Hemochromatosis

Back 14

Rare disease of iron metabolism, characterized by excess iron deposited throughout the body, may lead to cirrhosis and portal hypertention.

Front 15

Biliary obstruction: Proximal

Back 15

Proximal to the cystic duct can be caused by carcinoma of the CBD or metastatic tumor invation of the porta hepatis.
Clinical: jaundice and pruritus(itching), increased direct bilirubin and alkaline phosphatase
Sono:Mass difficul to visualize, GB is normal size even after fatty meal.

Front 16

Biliary obstuction: Distal

Back 16

May be caused by stones in common duct, and extrahepatic mass in the porta hepatis or stricture of common duct.
Common duct stonescause pain, jaundice, pruritus, increased direct bili and alkaline phosphatase.
Sono: Dilated intrahepatic ducts, gallstones, common duct stones.

Front 17

Extrahepatic mass

Back 17

Mass int he area of porta hepatis causes same clinical signs as seen in biliary obstruction.
Sono: Irregular, ill-defined, hypoechoic and inhomogenious mass lesion may be seen in area of porta hepatis. Intrahepatic ductal dilation and hydropic GB.
Caused by lymph nodes, Pancreatitis, pseudocyst, carcinoma of head of the pancreas.

Front 18

Passive hepatic congestion

Back 18

Develops secondary to congestive heart failure with signs of hepatomegaly, labs are normal or slightly elevated.
sono: dilated IVC, Sup mesenteric, hepatic, portal and splenic vein.

Front 19

Cavernous Hemangioma

Back 19

Mosot common benign tumor of the liver. consists of blood-filled cystic spaces. F>M.
sono: hyperechoic with acoustic enhancement.

Front 20

Liver cell adenoma

Back 20

Tumore of the glandular epithelium. Composed of normal or atypical hepatocytes, frequently contain areas of bile stasis and hemorrhage or necrosis
F>M, related to oral contraceptive.
Sono: Hyperechoic mass w/ central hypoechoic area caused by hemorrhage. may be solitary or multiple.

Front 21

Focal nodular hyperplasia

Back 21

Found in woman under 40 years of age. Increased incidence with use of oral contraceptives. assymptomatic, mostly in right lobe, have central scar.
Sono: well defined w/ hyperechoic to isoechoic patterns.

Front 22

Hepatocellular Carcinoma

Back 22

Related to cirrhosis, most common liver malignancy, M>F, may invade hepatic veins and cause Budd-Chiari syndrome.
Clinical: Palpable mass, hepatomegaly, unexplained fever, and signs of cirrhosis. Elevated alpha-fetorprotein.
Sono: Solitary of multiple lesions, hypo pr hyperechoic, isoechoic w/ halo, diffuse parenchymal inhomogeneity without distinct masses.

Front 23

Metastatic disease

Back 23

Most common form of neoplastic involvment of the liver. Primary sites are colon, breast, lung.
Clinical: Hepatomegaly, abnormal LFT's, weight lossand decreased appetite.

Front 24

Lymphoma

Back 24

Hepatomegaly w/ a normal or diffuse alternation of parenchymal echoes. A focal hypoechoic mass is sometimes seen. The presence of splenomegaly or retroperitoneal nodes help confirm diagnosis.

Front 25

Hodgkin's lymphoma

Back 25

Hypoechoic and diffuse ultrasound patterns in the liver

Front 26

Non-Hodgkin's lymphoma

Back 26

Appear with target and echogenic mass lesions.

Front 27

Lukemia

Back 27

Multiple small, descrete hepatic masses that are solid with no acoustic enhancement.
Bull's-eye appearance with dense central core may be present a a result of tumor necrosis.

Front 28

Budd-Chiari Syndrome

Back 28

Thrombosis of the hepatic veins or IVC.
Abdominal pain, Massive ascites, and hepatosplenomegaly.

Front 29

Schistomiasis

Back 29

Flulike parasite in polluted water, infected shellfish.
Causes narrowing and occlusion of smaller portal veins. causes portal hypertention.
Sono: Thick PV wall, decreased liver size.

Front 30

Hepatoblastoma

Back 30

#1 pediatric liver primary malignancy before age 2. Genetic.
Clinical: Abdominal enlargement, Hepatomegaly, palpable mass, abnormal LFT's. increased alpha-fetoprotein.
Sono:Solid echogenic mass, may have cystic areas nad calcifications.