Pathology

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1

Lymphocele

Collection of lymphatic fluid

septations

internal echoes

surgical complication - Spontaneous development is rare.

most commonly found in the retroperitoneal space.

2

Urinoma

encapsulated collection of urine

usually caused by trauma

3

acute haematoma

low echogenicty

may have a similar appearance to a cys

4

chronic haematoma

septae formation

calcification

appearance as a solid mass

5

Ureterocele

cystic structure projecting into the bladder can cause obstruction

caused by UTI

6

abscess

full of pus and debris

hypoechoic collection, mostly multiloculated

no vascularity within the collection

acoustic enhancement due to fluid content

an echogenic, vascular rim

7

hematoma

blood filled

8

seroma

pocket of clear serous fluid

sometimes develops after surgery

9

adenopathy

disease of the lymph nodes

10

Cirrhosis

late stage of scarring (fibrosis) of the liver

regenerating nodules

overall coarse and heterogeneous echotexture

splenomegaly

ascites

11

hepatitis

inflammation of the liver

12

hepatocellular carcinoma

cancer of the liver cells

13

Hydatid disease

parasitic disease of tapeworms

AKA Echinococcus

14

polycystic liver disease

multiple cysts in the liver

15

adenoma

benign tumor

begins with epithelial cells

16

Echinococcus

parasitic disease of tapeworms

AKA Hydatid disease

17

sclerosing cholangitis

inflammation, scarring, and destruction of the bile ducts

thickening of bile duct walls

18

pancreatitis

inflammation of the pancreas

might appear atrophic, calcified or fibrotic.

hyperechogenicity (often diffuse)

pseudocysts

presence of ascites

thickening of bile duct walls

acute - stone in distal CBD

19

choledochlithiasis

gallstones in the common bile duct

thickening of bile duct walls

20

Cholangiocarcinoma

cancer of the biliary ducts

thickening of bile duct walls

sludge or mass in ducts

21

Cholelithiasis

gallstones

22

Phlegmon

non-encapsulated collection of necrotic and edematous peripancreatic tissue

23

Pseudocyst

lesion that may appear as a cyst on scans, but lacks epithelial or endothelial cells

pancreatic pseudocyst is made of pancreatic fluids with a wall of fibrous tissue or granulation

24

pseudoaneurysm

injured causing blood to leak and pool outside the artery's wall. In a true aneurysm, the artery or vessel is enlarged, but the enlargement doesn't result from an injury and blood flows normally through the aneurysm

25

ascites

accumulation of fluid in the peritoneal cavity

26

cystadenoma

adenoma characterized by epithelium-lined cystic masses that contain secreted material

serous or mucinous

generally in the ovaries, salivary gland, or pancreas.

27

varices

is an abnormally dilated vessel with a tortuous course

28

Pheochromocytoma

neuroendocrine tumor of the medulla of the adrenal glands

29

Crohn's Disease

inflammatory bowel disease

thickened small bowel

hyperemic

diarrhea

abdominal pain

weight loss

fever

30

parathyroid hyperplasia

enlargement of all four parathyroid glands

31

portosystemic collaterals

AKA varices

develop via enlargement of pre-existing anastomoses between the portal and systemic venous

common sign of portal hypertension

32

Kaposi's sarcoma

common in AIDS

cancer that causes patches of abnormal tissue to grow under the skin, in the lining of the mouth, nose, and throat or in other organs.

33

focal nodular hyperplasia

benign tumor of the liver

well-defined

central scar

prominent blood vessels

which is the second most prevalent tumor of the liver

34

hemorrhagic cyst

bleeding occurs within a cyst

abdominal pain

35

portal vein aneurysm

very rare

36

portal splenic hypertension

hypertension in the portal veins caused by cirrhosis

dilated portal vein (>13mm)

biphasic or reverse flow in portal vein (late stage) hepatofugal

recanalisation of lig. teres vein:

portal-systemic collateral pathways (collateral vessels/varices)

splenomegaly

ascites

enlargement of coronary and left gastic

37

hepatic lipoma

hepatic fat tumor

38

Hepatic abscess

full of pus and debris

hypoechoic collection, mostly multiloculated

no vascularity within the collection

acoustic enhancement due to fluid content

an echogenic, vascular rim

39

Hepatic adenoma

benign tumor of the liver

hormone induced

begins with epithelial cells

40

Budd-Chiari syndrome

occlusion of the hepatic veins or IVC

ascites

liver enlargement

splenomegaly

heterogeneous echotexture

part of or the entire right hepatic vein with no flow or inappropriately directed flow

discontinuity between the main hepatic vein and the IVC

reversed flow in hepatic veins and intra and extrahepatic collaterals

portal vein changes such as hepatopetal or hepatofugal flow

low or no flow in the IVC or balanced bidirectional flow

thrombus or tumour within the IVC

increased resistive index within the hepatic artery - >0.75

abdominal pain

41

Candidiasis

fungus infection

42

liver metastasis from lung

hypoechoic

bull's eye lesion

43

liver metastasis from non-hodgkins lymphoma

hypoechoic

44

liver metastasis from cystadenocarcinoma of the ovary

cystic metastasis

45

liver metastasis from adenocarcinoma of the colon

calcified lesions

hetergeneous

46

liver metastasis from breast

hypoechoic

47

focal fatty sparing in the liver

increased echogenicity

focal hypoechoic area

anterior portal vein

48

Cavernous hemangioma

benign non-neoplastic hypervascular liver lesions

typically well defined hyperechoic lesions

10% present hypoechoic

most common benign tumor

49

Biloma

extrabiliary collection of bile

50

hepatoma

liver cancer

51

sarcoidosis

inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. In people with sarcoidosis, abnormal masses or nodules (called granulomas) consisting of inflamed tissues form in certain organs of the body.

52

pancreatic carcinoma

obstruction

nontender GB dilation

53

portal vein thrombosis

...

54

Abdominal aortic aneurysm

...

55

GB carcinoma

stones

irregular mass w hypervascularity

wall thickening

56

cholelithiasis

gallstones

57

angiosarcoma

tumour that arises from vascular structures

58

angiomyolipoma

uncommon benign hamartomatous hepatic mass lesion containing

blood vessel (angioid)

smooth muscle (myoid)

mature fat (lipoid) components

  • hyperechoic
  • single or multiple
  • round or lobulated
  • solid
  • fat containing mass lesions

commonly in the right hepatic lobe or kidney

presence of both fat and prominent vascularity in the same lesion

59

cholesterolosis

multiple small collections of triglycerides and cholesterol esters within the lamina propria of the gallbladder wall.

hyperechoic foci within the gallbladder wall

no posterior acoustic shadowing

when cholesterosis is focal, it forms cholesterol polyps

AKA Strawbery

60

adenomyomatosis

overgrowth of the mucosa GB wall

echogenic foci

comet trail

or v-shaped reverb

61

hydropic GB

fasting larger than 5.3 cm

62

acute cholecystitis

calculus obstruction of the GB neck or cystic duct

GB perforation

gangrenous cholecystitis

emphysematous cholecystitis

pancreatitis

63

acalculous cholecystitis

GB wall thick

murphy's sign

pericholecystic fluid

GB wall edema

nausea

vomiting

RUQ pain

64

tumefactive sludge

sludge taking on polypoid mass-like shape

low level echoes

should move

avascular

65

GB polyps

non shadowing polypoid

ingrowth into gallbladder lumen

immobile

66

Rokitansky-Aschoff sinus

small mucosal herniations into muscle layer

appear cystic or echogenic foci v shaped reverb

67

emphysematous cholecystitis

sever form of cholecystitis

gas-forming bacteria are present

ringdown

bright echoes

RUQ pain radiating to the back

vomiting

chills

fever

68

klatskin cyst

is a cholangiocarcinoma occurring at the confluence of the right and left hepatic bile ducts

69

choledochal cyst

congenital cystic dilatations of the biliary tree.

cystic lesion which communicates with the bile duct

  • abdominal pain
  • jaundice
  • abdominal mass
70

mirizzi cyst

extrinsic compression of a extra-hepatic billiary duct from one or more calculi within the cystic duct or gallbladder

71

cyst of oddi

...

72

peribiliary cyst

small collection of cysts

73

Acute pancreatitis

Pancreas inflamation

  • gallstones
  • hypoechoic lesions may indicate necrotic change
  • Pain
  • WBC elevation
  • enzymes elevation
  • diagnosis of vascular complications, i.e. thrombosis

most common cause is obstruction of the pancreatic duct

74

chronic pancreatitis

might appear atrophic

calcified or fibrotic

hyperechoic (often diffuse) often indicates fibrotic changes

pseudocysts

pseudoaneurysms

presence of ascites

pain

jaundice

75

porcelain GB

GB wall contains varying amounts of calcification

increased risk of GB carsinoma

76

pneumoblia

air in biliary tree

77

adenocarcinoma of the pancreas

tumor most often in head (60-70 yo men)

  • Hypoechoic to normal
  • Prominent pancreatic duct
  • Liver & lymph mets
  • Displacing tumor
  • weight loss
  • painless jaundice
  • N&V
  • blockage of CBD
  • palpable mass

most common ultrasound appearance hypoechoic mass

78

cystadenocarcinoma of the pancreas

malignant mass usually pancreatic duct

slow growing

mostly in females

  • Irregular lobulated tumor
  • Cystic
  • Thick walls
  • Frequenctly calcified
  • Hypoechoic mass
  • pain
  • palpable mass
79

Islet cell tumor

Endocrine tumor

80

insulinoma

rare tumor from beta cells and secretes insulin.

Most common functioning islet cell tumor. 90-95% benign. Mostly in body and tail

81

gastrinoma

rare tumor secretes excess of gastrin leading to ulceration in the duodenum, stomach and the small intestine

82

Acute tubular necrosis (ATN)

death of tubular epithelial cells that form the renal tubules

Most common cause of renal failure

  • asymptomatic
  • decreased consciousness/lethargy
  • decreased or no urine output
  • fluid retention
  • nausea and vomiting.
83

Renal vein thrombosis

...

84

Acute Glomerulonephritis

upper renal tract infection with associated renal pelvic,renal calyceal and renal parenchymal inflammation

  • particulate matter in the collecting system
  • abnormal echogenicity of the renal parenchyma
    • focal/segmental hypoechoic regions
    • mass like change
  • Blood or protein in the urine (hematuria, proteinuria)
  • High blood pressure
  • Swelling of your ankles or face (edema)
  • Frequent nighttime urination
  • Very bubbly or foamy urine
85

Renal Amyloidosis

amyloid builds up in your organs

  • enlarged kidneys - characteristic finding in acute stages
  • increased echogenecity
  • prominent medullary pyramids
86

Diabetes mellitus

too much sugar in blood

87

Transitional cell carcinoma

malignant tumor of the transitional epithelium, a tissue lining the inner surface of these hollow organs

commonly in the urinary bladder - men

posterior or lateral aspect or trigone

  • ultrasound limited a role
  • hydronephrosis
  • hematuria
  • dysuria
  • suprapubic pain
  • dilated ureter

most common primary neoplasm of the urinary bladder

bladder TCC is the most common tumour of the entire urinary system.

88

Renal cell carcinoma

cancer of the lining of the kidney tubules

most often in men ages 50 to 70.

most common renal malignancy

  • ultrasound limited
  • hypoechoic halo
89

renal oncocytoma

benign renal tumor

mistaken for renal cell carcinoma

  • well circumscribed mass
  • isoechoic
  • central scar may be visible
90

primary renal lymphoma

tumors that develop from lymphocytes

  • single/multiple
  • bilateral
  • multiple hypoechoic masses
  • enlarged
  • little internal vascularity
91

renal angiomyolipoma

benign renal neoplasm composed of vascular, smooth muscle and fat elements

  • hyperechoic lesion
  • posterior enhancement
  • cortical
  • can be numerous
92

Nephrocalcinosis

refers to the deposition of calcium salts in the parenchyma of the kidney.

two types medullary and cortical

  • echogenic pyramids
  • possible acoustic shadowing
93

Autosomal dominant polycystic disease

Dominant genetic cystic disease of the kidney

  • enlarged kidneys
  • cysts many
  • echogenic material within the cyst
  • Calcification
  • impaired renal function
  • hypertension
  • liver cysts in 30%
  • cysts maybe complicated by bleeding or infection
  • progressive renal failure
94

multicystic dysplastic kidney

multiple minute cysts being formed in utero in the affected kidney

  • multiple varying cysts
  • largest size non medial
  • renal sinus missing
  • Hyperechoic
  • usually diagnosed in utero
95

acquired cystic kidney disease

Many people with chronic kidney disease develop ACKD, a condition in which the kidneys develop fluid-filled sacs called renal (kidney) cysts

96

parapelvic cysts

simple cysts originate from the adjacent parenchyma and protrude into the renal sinus

can be confused with hydronephrosis

97

Renal hamartoma

benign tumor of disorganized parenchymal tissue

98

Acute pyelonephritis

upper renal tract infection with associated renal pelvic,renal calyceal and renal parenchymal inflammation

  • normal
  • enlargement
  • compression of sinus
  • heterogeneous
  • hypo or hyper
  • irregular mass
  • gass
  • Blood or protein in the urine (hematuria, proteinuria)
  • High blood pressure
  • Swelling of your ankles or face (edema)
  • Frequent nighttime urination
  • Very bubbly or foamy urine
99

emphysematous pyelonephritis

gas formation within the renal parenchyma - diabetic women

  • multiple echogenic foci
  • dirty shadowing
  • particulate matter in the collecting system
  • abnormal echogenicity of the renal parenchyma
    • focal/segmental hypoechoic regions
    • mass like change
100

Occlusion of renal artery

rare clinical condition which can happen due to in-situ thrombus or embolism

101

medullary cystic disease of the kidney

progressive tubular atrophy with glomerulosclerosis (chronic tubulointerstitial nephritis) and multiple small medullary cysts.

102

Wilm's Tumor

Wilms' tumor is a rare kidney cancer that primarily affects children

most common malignancy in the kidneys for children

  • large heterogeneous solid masses
  • displace adjacent structures.
  • Occasionally they may be mostly cystic
103

renal agenesis

missing kidney - bilateral is rare

compensatory hypertrophy

104

renal hypoplasia

part of a kidney does not fully develop in the womb

  • compensatory hypertrophy
105

Nephrectomy

surgical removal of a kidney

  • compensatory hypertrophy
106

Renal atrophy

gradually decline in effectiveness

  • compensatory hypertrophy
107

Papillary necrosis

ischemic necrosis of the renal papillae. Necrosis also occurs in the medullary pyramid

108

hydronephrosis

dilatation of the urinary collecting system

  • Causes:
    • ureteral stone
    • uterine fibroids
    • ureteropelvic junction obstruction
    • acute pyelonephritis
    • ovarian mass
109

over distension of bladder

bladder is stretched or overfilled

  • can be confused with hydronephrosis
110

Prominent hilar vessels

hilar region is the area through which blood vessels and nerves, etc., enter and leave the service of the kidneys

  • can be confused with hydronephrosis
111

large extrarenal pelvis

can be confused with hydronephrosis

112

renal failure

A condition in which the kidneys lose the ability to remove waste and balance fluids

  • small
  • hyperechoic
  • Lack of appetite
  • Nausea and vomiting
  • Tiredness
  • Difficulty sleeping
  • Dry and itchy skin
  • Nighttime muscle cramps
113

muscular hypertrophy

thickening of the bladder wall

114

endometriosis

lines the endometrium — grows outside your uterus

  • pain
115

crossed renal ectopic

both kidneys on same side

116

renal subcapsular hematoma

Renal trauma

perirenal fluid that flattens the underlying renal contour