Small Parts

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Follicular Adenoma

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Benign neoplasm encapsulated by fibrous tissue usually solitary and well defined

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Follicular Adenoma More Common In ...

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Women

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Follicular Adenoma Sono Appearance

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solitary, round or oval, less echogenic than surrounding area

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Follicular Adebnoma is present in what number of cases

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50%

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how many solitary masses are adenomas

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30-50%

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In a nuclear medicine scan, folliclar adenomas are

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cold

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"hot" nuclear medicine

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hyperfunction nodule that absorbs a large amount of radionuclide

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"cold" nuclear medicine

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hypofunction nodule absorbs little radionuclide

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Malignancy probability of "cold" solitary nodule

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15-20%

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"cold" can be produced by

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cysts, nonfunctioning benign growths, localized inflammation or cancer

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Multinodular goiter are frequently found in

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Females , 10-20x

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Multinodular goiter seen in what age

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50-70 years

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Multinodular goiter appearance

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diffuse, inhomogeneousm enlarged gland
may appear as multiple nodules throughout a normal appearing gland
calcifications may be present

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Benign Nodules are suggested when

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There is a multiplicity of nodules

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Endemic goiter caused by

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Dietary Insufficiency of Iodine

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Endemic Goiter usually found in areas where

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away from sea with idoine depleted soil

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Incidence of endemic goiter in area defined

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10% of children 6-12 years old

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Hashimoto thyroiditis

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chronic inflammation of thyroid gland that results in hypothyroidisms

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Hashimoto thyroiditis seen in what age

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middle aged women

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Hashimoto thyroiditis caused by

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reaction of immune system against thyroid gland

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Hashimoto thyroiditis development

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may take months or years to be detected

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Estimated % of adults in western countries with chronic thyroiditis

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.1-5%

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Hashimoto thyroiditis sono appearance

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enlarged, hypoechoic, course, discrete nodules can be present with calcifications

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Hashimoto and goiter distinguished by

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clinical and lab criteria

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Thyroid cysts contian

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solid or blood

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Adenomatous nodules

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most cysts, undergone degeneration or necrosis

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Grave's disease

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"toxic multinodular goiter"

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Grave's Disease is

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an autoimmune disease that cause overactivity of thyroid

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Grave's Disease sono appearance

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diffusely enlarged, hypoechoic
increased vascularity

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Thyroid cancer %

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.4% of deaths in US

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Thyroid Cancer age range

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40-60

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Thyroid cancer mostly seen in

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Females 2x

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Thyroid cancer sono appearance

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varied
commonly hypoechoic, poorly defined borders, incomplete halo , fine internal calcificaitons

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Most common thyroid cancer

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Papillary carcinoma, 60-70%

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Papillary Carcinoma

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slow growing tumor
may be solid or cystic

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Follicular Carcinoma %

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25%

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Follicular Carcinoma

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slow growing but aggresive

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Follicular Carcinoma mets to

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lung and bone

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Follicular Carcinoma are more common in

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females

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Medullary carcinoma %

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5-10%

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Medullary carcinoma sono appearance

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hypoechoic nodes with focal hemorrhage or necrosis

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Parathyroid adenomas

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benign tumors extremely small

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Parathyroid occurs

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single affecting only one gland

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Parathyroid sono appearance

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uniformly solid, occasionally internal cystic or calcificaitons are possible

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Parathyroid lab values

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elevated PHT

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Parathyroid hyperplasia

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all glands are involved

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parathyroid hyperplasia sono appearance

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appear like adenomas
differentiation is number of glands involved

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parathyroid cancer causes

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hyperparathyroidism and very high calcium levels

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parathyroid cancer sono appearance

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larger, more lobulated and inhomogenous

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thyroglossal duct cyst

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congenital anomaly found in midline of neck

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Branchial cleft cyst

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cystic mass seen lateral of neck near carotid

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cystic hygroma

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congenital lymphatic malformation caused by either inadequate drainage or the lymphatic fluid into the jugular vein or increased secretion from endothelial lining

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cystic hygroma sono appearance

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thin walled multiloculated mass

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Hydrocele

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fluid in tunica vaginaliss

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hydrocele results from

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congenital, idiopathic or from epididymitis or trauma

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Hydrocele sono appearance

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anechoic, surround testicle and epididymitis
small particles and septations

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Hematocele

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blood in sac

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pyocele

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pus in sac

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spermatocele

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benign cyst or distension with fluid of spermativ cord

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Spermatoceles usually found in

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head of epididymis next to top of testicle

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epididymital cyst

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Swelling of sperm collecting tubes around in head of testis

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Tunica albugenea cyst seen in

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men 50-60

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Tunica albugenea cyst appearance and location

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painless lump
anterior and lateral to testicle

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Epididymitis

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inflammation of the epididymis

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Most common cause of acute scrotal pain

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epididymitis

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epididymitis symptoms

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fever

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epididymitis sono appearance

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enlarged epididymis, decreased echogenicity, hydrocele, increased doppler flow, may spread to testicle

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orchitis

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inflammation of tests

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Most common cause of orchitis in men under 35

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Chlamydia

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Orchitis sono appearance

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decreased echogenicity heterogenous
increased flow

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Torsion

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arteries and veins of spermatic cord twists or rotates to cut off blood supply to testicle

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Torson longer than 12 hrs

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complete infraction of testicle

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torsion common in

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males on left

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Bell Clapper deformity

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epididymitis and testis not properly anchoird posteriorly letting testicle move freely

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Torsion symptoms

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acute scrotal pain, nausea, vomiting

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torsion sono appearance

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first 24 hrs- enlarged with decreased echogenicity
chronic- small heterogenous no arterial flow

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varicocele

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enlargement of veins of spermatic cord

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most common cause of infertility

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vericocele

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cericocele of left and righ

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left- most common
right- associated with renal tumor

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microlithiasis

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calcifications throught the testes

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microlithiasis associated with

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seen in normal patients
associated with tumors, sterility and cryptochidism

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microlithiasis sono appearance

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multiple echogenic non shadowing areas throuhgt the testis

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Abscess (scrotum)

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caused by untreated epididymop-orchitis

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Scrotal malignancies occur at what age

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25-35

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scrotal malignancies sysmtoms

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chronic pain, heaviness,

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germ cell tumors most common

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seminoma

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seminomas appear

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homogenous and hypoechoic until they become large at which point they become heterogenous

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seminomas confined within

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the tunica albuginea

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Seminomas seen in

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men 30-40