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A patient returns from travelling abroad. Her liver appears enlarged and hypoechoic, with accentuated brightness of the portal triads. The GB wall also appears thick. What is likely the cause?
What are the causes of fatty liver?
**Obesity
Alcoholism
Pregnancy
Glycogen Storage Disease
Chemotherapy
What's the second most common liver neoplasm?
FNH
A hypoechoic liver mass with a hyperechoic halo is found in a 53 year old patient with a history of obesity. The patient presents with RUQ pain, weight loss and abdominal bloating. What is likely the diagnosis?
Hepatocellular carcinoma
A patient has both renal angiomyolipomas and a rare neoplasm, hepatic lipoma. What does this patient also likely have?
Tuberous sclerosis
A patient presents with fever, jaundice, malaise and right upper quadrant pain. On ultrasound, there is a cystic structure with echogenic fluid within and posterior reverbertation artifact. What is likely going on?
Pyogenic liver abscess
Hemangiosarcoma/angiosarcoma's are rare tumors develop due to?
Carcinogens such as thorotrast, arsenic and polyvinyl chloride.
A known alcoholic patient comes in for an abdominal ultrasound. What would be the findings?
Micronodular cirrhosis (0.1-1.0cm nodules)
A hospitalized patient presents with a persistent fever. Upon ultrasound, a large mass is noted within the liver which has a "wheel within a wheel" appearance. This is likely?
Hepatic candidiasis
RHV
A patient with known hepatitis comes in for an abdominal ultrasound. What size of nodules would be likely seen in the liver?
Macronodules >1cm
(Micro=alcoholism, Macro=hepatitis)
Gastroesophageal junction, paraumbilical vein, splenorenal & gastrorenal, intestinal and hemorrhoidal
What benign tumor is important due to its frequency and severity of life threatening complications (malignant transformation & bleeding)?
Adenomas
A hyperechoic lesion is seen on the liver of someone with known cancer. What is the primary form of cancer that metastasizes to the liver?
GB, colon, stomach, pancreas, breast and lung. Lung is most common
A patient has known chronic hepatitis. What does the liver appear as?
Usually appears as normal. Also can appear cirrhotic and with coarsened echotexture
What's the primary cause of intrahepatic portal hypertension?
Cirrhosis
A patient has been on OCP's for 20years. Upon ultrasound examination, it is discovered that she has an enlarged and hyperechoic liver. The hepatic veins are not visualized and there are intrahepatic collaterals. What is likely the diagnosis?
Budd Chiari Syndrome
Liver metastases from RCC, neuroendocrine tumors, carcinoid, choriocarcinoma and islet cell tumors often have what appearance? Why?
Hyperechoic. Echogenic metastases likely have a gastrointestinal origin. The most vascular the tumor is, the more echogenic it will be
A subtle, isoechoic mass is seen on the liver of a young female patient. The vascular mass appears to be distorting the contour of the liver very slightly, displacing the vessels, and has a hypoechoic "scar" through the lesion. The patient has no symptoms. What is most likely the diagnosis?
Focal nodular hyperplasia
A hyperechoic, calcified 12cm mass appears on the liver of a 34yr old female patient. The patient complains of RUQ pressure. What is likely the result of this mass? What will be the course of action for this mass?
Adenoma
Surgical resection will likely be the treatment, as adenomas have the potential to hemmorhage or become maligant
A patient returns from the Middle East and presents with a large cystic structure with daughter cysts in the right lobe of the liver. What is likely the diagnosis?