Gih Week 2: Neoplasia And Tumor-Like Conditions

Front 1

Are the hepatic cysts formed in polycystic liver disease inherited or acquired?

What disease is this often associated with?

Back 1

Inherited

Associated with polycystic kidney disease

Front 2

Are nodular hyperplasias more common in men or women?

Back 2

Women

Front 3

Which tumor-like condition appears as tan nodules (may or may not be bile stained) with a central scar? Histologically, they show a heavy lymphocytic infiltrate.

Back 3

Nodular hyperplasia

Front 4

What is the most common benign tumor found in the liver?

Back 4

Hemangiomas

Front 5

Which liver neoplasm arises from blood vessels and are spongy and darker than the surrounding tissue?

Back 5

Hemangioma

Front 6

An unusual pattern that consists of diffuse angiomatoid lesions throughout the liver.

Back 6

Peliosis hepatis
(can be seen in hemangiomas)

* Randomly distributed multiple blood-filled cavities throughout the liver

Front 7

Which liver neoplasm is a well-encapsulated, benign (but potentially malignant) tumor that usually is found in infant girls?

Back 7

Hemangioendothelioma

Front 8

What symptoms might be present with hemangioendothelioma?

Back 8

1. Jaundice
2. Hepatomegaly

Front 9

Which liver neoplasm might result in congestive heart failure due to arterio-venous shunts that form from the liver?

Back 9

Hemangioendothelioma

Front 10

What condition is seen in 20-40% of angiosarcoma patients?

Back 10

Cirrhosis

Front 11

Angiosarcomas have been linked to exposures of what 2 chemicals?

Back 11

1. Vinyl chloride
2. Thorotrast (radioactive suspension that used to be used in contrast x-rays)

Front 12

List 3 liver neoplasms of vascular origin.

Back 12

1. Hemangioma
2. Hemangioendothelioma
3. Angiosarcoma

Front 13

Unlike liver adenomas, bile adenomas are more frequent in who?--males or females?

Back 13

Males

Front 14

Describe the appearance of bile duct adenomas.

Back 14

Small encapsulated, spherical, yellow-white nodules.

Front 15

What neoplasm arises from bile duct epithelium and forms acini or papillary structures lined by mucous secreting cells? Abundant fibrosis creates a sclerotic pattern which may stimulate a metastatic adenocarcinoma.

Back 15

Cholangiocarcinoma

Front 16

What are some key ways that cholangiocarcinoma differs from hepatocellular adenocarcinoma.

Back 16

Unlike hepatocellular adenocarcinoma, cholangiocarcinoma:
1. It is NOT associated w/ cirrhosis
2. alpha-fetoprotein is NOT elevated
3. It does NOT produce bile
4. Metastasize earlier and more widely

Front 17

Liver flukes increase the risk of what type of neoplasia?

Back 17

Cholangiocarcinoma

Front 18

Thorotrast exposure increases the likelihood of what type of liver neoplasia?

Back 18

1. Angiosarcoma
2. Cholangiocarcinoma
3. Hepatocellular carcinoma

Front 19

Which hepatic neoplasm is almost always seen before the age of two?

Back 19

Hepatoblastoma

Front 20

Which type of hepatic neoplasia may consist of fetal and embryonal type hepatocytes with primitive spindle cells, osteoid tissue, cartilaginous tissue, and muscle cell elements?

Back 20

Hepatoblastoma

(Seen in very young patients-- usually under the age of two.)

Front 21

Which type of hepatic neoplasm runs a special risk of peritoneal hemorrhage in pregnant women?

Back 21

Liver adenoma

(May hemorrhage when subcapsular)

Front 22

Liver adenomas are more often seen in which individuals?

They may also be associated with what type of medication?

Back 22

Young women

Oral contraceptives

Front 23

Which type of hepatic neoplasm is rampant in parts of Asia and Africa where Hepatitis B is prevalent?

Back 23

Hepatocellular carcinoma
(hepatoma)

Front 24

Hepatocellular carcinoma is highly associated with what liver condition?

Back 24

Cirrhosis

(About 80% of hepatocellular carcinomas arise in cirrhotic livers)

Front 25

What type of hepatatic neoplasia should you suspect in cirrhotic patients who suddenly develop an enlarged liver, ascites, or deteriorating hepatic function?

Back 25

Hepatocellular carcinoma

Front 26

What does the clinical presentation of hepatocellular carcinoma include?

Back 26

(In order from most common --> least common)

1. Hepatomegaly
2. Abdominal pain
3. Abdominal mass
4. Jaundice
5. Fever

Front 27

What tumor marker may be increased in hepatocellular carcinoma, but is not specific for this disease?

Back 27

alpha-fetoprotein

Front 28

Patients with hepatocellular carcinoma are at risk for developing what conditions? (4)

Back 28

1. Polycythemia
2. Hypercalcemia
3. Hyperlipemia
4. Hypoglycemia

Front 29

How do most patients die from hepatocellular carcinoma?

Back 29

1. Liver failure
2. Bleeding
3. Inanition (prolonged undernutrition)

(usually die within 6 months of diagnosis)

Front 30

What color may hepatocellular carcinomas be?

Back 30

Yellow-white or various shades of green

Front 31

Is bile pigmentation frequent in hepatocellular carcinomas?

Back 31

Yes
(This is because there is no functional drainage through bile ducts)

Front 32

Where do hepatocellular carcinomas generally spread?

Back 32

Lungs
(hematogenous spread through hepatic veins)

Front 33

Which hepatic neoplasm might produce a Budd-Chiari syndrome due to hepatic vein obstruction?

Back 33

Hepatocellular carcinoma

Front 34

In hepatocellular carcinoma, is fibrous stroma development abundant or sparse?

Back 34

Sparse--very little fibrous stroma is present in hepatocellular carcinoma

Front 35

What are the 4 'PRINCIPAL FUNCTIONS' of the 'NERVOUS SYSTEM'?

Back 35

1. ORIENTATION of the body
2. COORDINATION and control of the body
3. ASSIMILATION of experiences requisite to memory
4. PROGRAMMING of instinctual behavior (more important in vertebrates other than humans)

Front 36

What organs often serve as the metastatic origin of liver malignancies?

Back 36

1. *Colon
2. Pancreas
3. Lung
4. Kidney
5. Breast

Front 37

T or F.

Hemangiomas are usually of no clinical importance.

Back 37

TRUE

Front 38

This neoplasm consists of pleomorphic endothelial cells with large hyperchromatic nuclei, giant cells in frequent mitosis, and irregular vascular channels.

Back 38

Angiosarcoma

Front 39

Which hepatic neoplasm will occasionally extend directly from the hepatic vein into the right side of the heart via the inferior vena cava?

Back 39

Hepatocellular carcinoma