Liver Pathology

Front 1

Granulomas

Back 1

small calcifications in the liver and spleen

Front 2

Granulomas

Back 2

caused by histoplasmosis or tuberculosis infection

Front 3

Hepatitis

Back 3

Liver inflammation resulting from infections. May result in elevation of ALT, AST, and unconjugatedb bilirubin

Front 4

Acute hepatitis

Back 4

Hypoechoic liver, liver enlargement, hyperechoic, prominent portal vein walls.

Front 5

Acute hepatitis

Back 5

Appearance sometimes referred to "Starry Night"

Front 6

Chronic hepatitis

Back 6

Hyperechoic liver parenchyma, small liver, decreased echogenicity of portal vein walls

Front 7

Pyogenic (bacterial) Abscess

Back 7

Occurs commonly in the rt lobe of liver. Complex mass; echogenic gas; reverberation artifact

Front 8

Amebic Abcess

Back 8

Occus when a parasite (amoeba) from the intestines reaches the liver via the portal vein. Poss from drinking water in a 3rd world country

Front 9

Fungal Abscess (Candidiasis)

Back 9

mycotic infection of the blood that results in small abcesses in the liver. Appearance of lesions may change over time

Front 10

Fungal Abcess (Candidiasis)

Back 10

The earliest manifestation of this lesion appears as a "wheel within a wheel"

Front 11

Echinococcal Cyst (Hydatid disease)

Back 11

result of a tapeworm infestation assoc. with sheep and cattle raising countries

Front 12

Echinococcal Cyst (Hydatid disease)

Back 12

may see Cyst with detached endocyst (cyst within a cyst) or multiple daughter cysts

Front 13

Echinococcal Cyst (Hydatid disease)

Back 13

uses the Casoni skin test with 70% sensitvity for diagnosis

Front 14

Schistosomiasis

Back 14

one of the most common parsitic infections in humans. It is the major cause of portal hypertension world-wide.

Front 15

Acquired Immunodeficiency Syndrome (AIDS)

Back 15

Pneumocystic carinii is the most common organism causing infection in patients with this disease. The carinii organism is usually responsible for Pneumocystis pneumonia

Front 16

Acquired Immunodeficiency Syndrome (AIDS)

Back 16

Lymphoma and Kaposi's sarcoma may be seen as an intrahepatic mass or possibly diffuse infiltration without visualization of a sonographic abnormality

Front 17

Fatty Infiltration

Back 17

the accumulation of triglycerides within the hepatocytes.

Front 18

Fatty Infiltration

Back 18

Patients may also carry the diagnosis of type II diabetes; obesity: and /or hypertriglyceridemia

Front 19

Fatty infiltration

Back 19

liver appears as increased echogenicity overall or focally at the porta hepatis

Front 20

Focal fatty sparing

Back 20

focal regions of normal liver parenchyma within a fatty infiltrated liver.

Front 21

Cirrhosis

Back 21

diffuse process of fibrosis and distortion of normal liver architecture.

Front 22

Cirrhosis

Back 22

causes may include; hep C, Alcoholic liver disease...

Front 23

Hepatitis C

Back 23

now the nation's leading cause of both chronic hepatitis and cirrhosis.

Front 24

Portal Hypertension

Back 24

Increased pressure in the portal venous system

Front 25

Portal Hypertension

Back 25

Cirrhosis is the major cause

Front 26

Portal Hypertension

Back 26

Sonographic findings of this include the secondary signs of Splenomegaly, Acites, and portal systemic venous collaterals

Front 27

Portal systemic collaterals

Back 27

created by connecting the portal system to the inferior vena cava: bypassing the liver

Front 28

Gastroesophageal varices

Back 28

collaterals of the distal esphagus and gastric fundus.

Front 29

Recanalized umbilical vein

Back 29

re-opening of the ligamentum teres to act as a collteral from the left portal vein to epigastric veins to the IVC

Front 30

Portal Hypertension

Back 30

can be seen as dilated veins on anterior abd wall

Front 31

Caput Medusa

Back 31

tortuous collaterals around the umbilicus. can be in assoc. with portal systemic collateralization.

Front 32

TIPS

Back 32

Transjugular Intrahepatic Portal-systemic Shunt

Front 33

Transjugular Intrahepatic Portal-systemic Shunt

Back 33

A shunt place in cases of severe portal hypertension

Front 34

Transjugular Intrahepatic Portal-systemic Shunt

Back 34

placed between a hepatic vein and a portal vein. typically the RHV and RPV

Front 35

widely patent TIPS should demonstrate

Back 35

hepatofugal flow in the RPV and LPV

Front 36

Liver transplant

Back 36

performed in severe cases of cirrhosis and viral hepatitis.

Front 37

viral hepatitis

Back 37

the leading cause of liver cancer and the most common reason for liver transplantation

Front 38

Portal vein thrombosis

Back 38

can appear as cavernous transformation

Front 39

Cavernous transformation

Back 39

numerous worm-like venous collaterals that parallel the chronically thrombosed portal vein. typically seen with benign causes such as cirrhosis.

Front 40

Budd-Chiari Syndrome

Back 40

a disorder characterized by hepatic vein obstruction by thrombus or tumor. typically seen in young adult woman taking birth control pills

Front 41

Budd-Chiari Syndrome

Back 41

the caudate lobe is often spared because the emissary veins drain directly into the inferior vena cava thus, the caudate lobe enlarges with atrophy of the right and left lobes

Front 42

Portal vein gas

Back 42

uncommon condition where air is noted within the intrahepatic portal veins

Front 43

Portal vein gas

Back 43

assoc with ischemic bowel disease such as ulcerative colitis or Chron's desease

Front 44

Portal vein gas

Back 44

in infants this is due to necrotizing entercolitis

Front 45

liver cysts

Back 45

usually refer to nonparasitic simple cysts

Front 46

hemorrhagic cyst

Back 46

will appear as a cyst with internal echoes accompanied by RUQ pain and a decreasing hematocrit

Front 47

Cavernous hemangioma

Back 47

most common benighn tumor of the liver. sonographically may demonstrate posterior enhancement

Front 48

Focal Nodular Hyperplasia

Back 48

benign solid liver mass that is believed to be a developmental hyperplastic lesion related to an area of congenial vascular malformation

Front 49

Focal Nodular Hyperplasia

Back 49

with this mass the patient is usually asymptomatic and it is more common in women than men

Front 50

Focal Nodular Hyperplasia

Back 50

may appear as iso-attenuating thus, may be referred to as Stealth lesion

Front 51

Hepatic Adenoma

Back 51

assoc with glycogen storage disease and the use of contraceptive agents

Front 52

Hepatic Lipoma

Back 52

rare fatty tumors. often assoc with Tuberous sclerosis, a congenital familial disease.

Front 53

Hepatic Lipoma

Back 53

Assoc with the propagation speed artifact

Front 54

Hepatocellular Carcinoma

Back 54

most common primary malignancy of the liver

Front 55

Hepatocellular Carcinoma

Back 55

occurs in 10-25% of patients with cirrhosis in the US

Front 56

Hepatocellular Carcinoma

Back 56

assoc with increased alpha fetoprotein, AST, ALT

Front 57

Metastatic Disease

Back 57

most commonly encountered solid masses of the liver. Multiple

Front 58

Most common primary sites for liver Mets

Back 58

gastrointestinal, breast or lung

Front 59

sono appearance of liver mets from gastrointestinal tract primary

Back 59

hyperechoic mets

Front 60

sono appearance of liver mets from lymphoma primary

Back 60

hypoechoic

Front 61

most common sono appearance of liver mets from lung as primary

Back 61

Bull's eye or target mets

Front 62

most common sono appearance of liver mets from mucinous adenocarcinoma

Back 62

calcified mets

Front 63

most common sono appearance of liver mets from sarcoma

Back 63

cystic mets

Front 64

Hepatoblastoma

Back 64

most common malignant liver tumor in early childhood

Front 65

Hepatoblastoma

Back 65

assoc with elevated alpha fetoprotein, and genetic conditions such as Beckwith-Wiedemann syndrome.

Front 66

AST=SGOT

Back 66

elevation by itself is non-specific for liver disease

Front 67

ALT=SGPT

Back 67

lab value is more specific for liver disease

Front 68

Alpha Fetoprotein=AFP

Back 68

lab value elevated with Hepatocellular Carcinoma (Hepatoma)