liver pathology review

An extremely high level of ____ in your blood greater than ____ ng/ML could be a sign of liver tumors

AFP, 400

2 important blood serum tests to evaluate the liver are ____ and ____, with ALT being the most signifacant for liver disease

AST, ALT

a liver greater than ____ to ____ is considered enlarged, medically we refer to it as _____

15.5, 16, hepatomegaly

Another medical term for fatty liver is ______, and it is mainly caused by _____ and obesity

steatosis, alcohol

a common location for focal fatty sparing is around the _______ ______, fat sparing means that the entire liver is fatty ____ in that area

porta hepatis, except

fatty liver

focal fatty sparing

focal fatty infiltration

Diffuse Fatty Infiltration

Liver cell adenoma is often ____ unless it is type ___ or ____

benign, 2, 3

Von Gierke disease is also known as _______ which is a disease characterized by the liver not having control over the use of glycogen

glycogen storage disease

adenoma type 2 and 3 are often associated with ______ and _____

cirrhosis, HCC

_________ and __________ can cause a stary sky appearance of the liver

acute hepatitis, AIDS

Hepatitis ___ is something we should be aware of as sonographers since we can be infected by it in the hospital

B

Starry sky appearance

sono appearance of chronic hepatitis can mimick the appearance of ________

fatty infiltration

_______is a general term used when diffuse process destroys the normal liver, and parenchymal cells degenerate

cirrhosis

Most common causes for cirrhosis are _______, _______ and ______

hepatitis, viruses, alcohol abuse

Cirrhosis increases an individuals risk for ________

HCC-hepatocellular carcinoma

Some symptoms of cirrhosis are _____ , ______, _______

jaundice, abdominal swelling, fatigue

abnormal hepatofugal flow

hypertrophic caudate lobe

an enlarged _____ _____ is a key highly specific indicator of cirrhosis.

caudate lobe

secondary signs of cirrhosis are ______, ______, ______

splenomegaly, varices, ascietes, portal hypertension

the ____ vein is the most commonly involved portal systemic collateral pathway in liver cirrhosis. Is is seen in about ____ of cirrhosis cases.

coronary, 80

esophageal varices

with cirrhosis of the liver, the hepatic veins lose their triphasic pattern and become ______

monophasic

TIPS stands for ____________

transjugular intrahepatic portosystemic shunt

Transjugular intrahepatic portosystemic shunt (TIPS) is a connection between a _____ vein and the ______ vein within the liver

Hepatic (R), portal (R)

TIPS is performed to treat severe _____ _______ and is used to stabilize patients while they wait for a _____ ____

portal hypertension, liver transplant

normal TIPS velocity is ____ to _____

90, 190 cm/s

portal vein before entering tips is _____

30 cm/s

abnormal liver capsule

True heaptic cysts are those that are _____

congenital

simple liver cysts

a congenital cystic disease is _____ ____ _____ and it can be due to a defect in the formation of ___ ____

polycistic liver disease PLD, bile ducts

polycistic liver disease is more common in ______ and becomes detectable in the ages of ___ and ___

women, 30s, 40s

polycistic liver disease

when you see polycistic livers. you should also evaluate the _____

kidneys

bleeding within a simple cyst is termed _____ and it causes hematocrit to ______. May result in ______ if it keeps reoccuring

hematoma, drop, calcification

_____ ____-acquired cysts are most commonly caused by Taenia _______

Hydatid, echinicoccal cyst

hydatid disease, (calcified singular and mother/daughter)

common parasitic infection caused by parasitic tapeworms ________

schistosomiasis

in schistosomiasis, the biggest problem are _____ as they are the source of infection

eggs

Schistosomiasis (tortoise shell)

Schistosomiasis (tortoise shell)

in schistosomiasis, we can expect to see _____ with ____ vein and ___vein dilatation and hepatic function mostly normal until late stages

splenomegaly, portal, splenic

_______ ______ sarcoma is the most common hepatic neoplasm in patients with AIDS, it is typically _____ and rarely diagnosed in life and causes starry sky

Hepatic Kaposi, asymptomatic

most common benign solid lesion of the liver are _____ ______

cavernous hemangiomas

cavernous hemangioma

Second most common benign liver mass.

focal nodular hyperplasia

A central scar is a classic imaging feature of ___________

Focal Nodular Hyperplasia

Focal Nodular Hyperplasia (FNH)

Focal Nodular Hyperplasia (FNH)

FNH

Liver cell adenoma

different from FNH but also associated with long term use of oral contraceptives and are 4:1 more common in women _______, instead of internal vascularity, it can have ___ ____ vascularity

liver cell adenomas, peripheral

liver cell adenoma

80 to 90 percent of the primary malignant tumors of of the liver are _____

Hepatocellular carcinomas AKA hepatoma

second most common malignant liver tumor is ______

cholangiocarcinoma

HCC is most common in ______ population and in ____

African American, men

biggest predisposing factor to HCC is chronic liver disease like _______

cirrhosis

LFT that are elevated with HCC are ___, ___, ___

ALP, AST, ALT

___is the most significant elevated test for HCC it elevates in 70 percent of patients

AFP

HCC invades ______ in about 60 percent of patients

portal vein

HCC/hepatoma

___ __ tumors are more common than HCC/hepatoma

metastatic liver

common cancers that metastasize to the liver are ____

GB, colon, stomach, pancreas, kidneys, ovaries, breast, lungs

metastatic liver cancer has increased ________

vascularity

metastases

METS

metastatic liver cancer can have elevated ___ ___ ____, but ____ is not typically elevated

AST, ALT, ALP, AFP

METS LFT values may also present as ______

normal

metastases lung cancer

metastases lung cancer

bulls eye target lesion (METS)

post liver transplant hepatic artery evaluations of less than ____ RI or a _______ _____ waveform is indicative of possible complications

0.5- 0.6, tardus parvus

post liver transplant PV and HV gets evaluated via doppler to ensure ______ flow, and HV patency to rule out,

hepatopetal, obstruction

budd-chiari syndrome

outflow obstruction caused by hepatic venous obstruction

budd chiari syndrome

Most opportunistic infection in HIV infected persons is

Pneumocystis jiroveci

Focal nodular hyperplasia can have ———— pattern

Spokewheel

FNH (spokewheel)

The ————in serum is currently available diagnostic marker for HCC discovery.

As for patients with chronic liver disease, a sustained increase in serum level was shown to be one of the risk factors of HCC and has been used to help identify high-risk subgroup of chronic liver disease

AFP

Hemochromatosis (iron)

abcess

Multiple adenomas

FNH

HCC

FNH

Echinoccocal Cyst (hydatid liver cyst)

Liver congestion, heart failure

Bud Chiari Syndrome

Schistosomiasis

Acute Hepatitis