Most Common Neoplasms

neuroblastoma

The 2nd most common abdominal tumor of childhood, between ages 2 months and 2 years. It arises from the adrenal gland or the sympathetic nervous chain. Extra renal in location, displaces and compresses the kidney Its spread around the aorta and celiac and superior mesenteric arteries occurs early and helps to distinguish from Wilms'tumor at sonography. poorly defined, heterogeneous, irregular hyperechogenic areas caused by calcifications

hypothyroidism

The classic lab finding ss a high TSH with low free T4. Weight gain, swollen neck -enlarged thyroid, hair loss, constipation, heavy period, depression, high cholesterol. (accounts for 90% of all thyroid imbalances.)

hypoechoic

The most common echogenicity of an acutely inflamed pancreas is

transjugular intrahepatic portosystemic shunt (TIPS)

Treatment for portal hypertension- essentially bypassing the problem - Decreases the build up of ascites , preventing hemorrhaging of gastroesophageal varicies - Decompresses the high pressure portal system directly into the low pressure hepatic venous system -normal velocity 90-190cm/s

acute tubular necrosis

What is the most common cause of acute renal failure?

transition zone

What is the site in the prostate for most BPH?

IVC and renal vein

What should you always assess for with tumour spread of RCC?

peripheral zone

What zone of the prostate is the site for approximately 70% of prostate cancers?

hyperparathyroidism

a cause of medullary nephrocalcinosis.

Schistosomiasis

a chronic result of the deposition of eggs into small portal venules leading to periportal fibrosis and liver cirrhosis.

echogenic

a majority of Foreign bodies are of what echogenicity?

intrapleural pressure

always negative which is the reason why the lungs do not collapse. If for any reason this pressure becomes equal to atmospheric pressure, the lungs will collapse causing pneumothorax.

cushing syndrome

an abnormal bodily condition that is caused by excess corticosteroids and especially cortisol usually from adrenal or pituitary hyperfunction and is characterized especially by obesity, hypertension, muscular weakness, and easy bruising.

retroperitoneal fibrosis

an uncommon fibrotic reaction in the retroperitoneum that typically presents with ureteral obstruction.

malignant melanoma, lung, gastric, or breast cancer

bladder mets primaries.

wilm's tumor (nephroblastoma)

calcification uncommon: 10-15% displaces adjacent structures without insinuating between them well circumscribed claw sign with the kidney slightly older age group: peak 3-4 years of age extension into IVC/renal vein

neuroblastoma

calcification very common: 90% encases vascular structures but does not invade them younger age group (<2 years of age) poorly marginated more common to have extension into the chest elevates the aorta away from the vertebral column more commonly crosses the midline, especially behind the aorta

exudative pleural effusion

caused by inflammation leading to increased capillary permeability.

less than 0.7

considered normal RI for kidney.

transudative pleural effusion

effusions caused by fluid leaking due to increased pressure in the blood vessels.

resistive index

gives an indication of renal function. Measured in segmental/ interlobar arteries within the parenchyma.

ring down or comet tail artifact

glass will have what artifact associated with it

pulsatile waveform due to proximity to the heart (ASVD)

hepatic vein flow

abdominal wall masses

incude cysts/ hydroceles, lipoma, hematoma, desmoid tumors, endometrioma, fibroma, and fibrosarcomas.

peritonitis

inflammation of the peritoneum, the serous membrane that surrounds the abdominal cavity and covers its organs. Causes include infectious (bacterial) and non infectious (chemical, granulomatous, or sclerosis). SONOGRAPHIC APPEARANCE Particulate ascites Loculated ascites Septated, debris or gas within the ascites Diffuse thickening of the parietal and visceral peritoneum, mesentery or omentum Heterogenous exudate

Von Hippel-Lindau disease

inherited disorder associated with the development of tumors of the central nervous system and orbits, renal cysts, and adrenal tumors. Cysts within the pancreas.

post paracentesis circulatory dysfunction

large volume paracentesis >5 liters induces arterial vasodilatation and decreases arterial blood volume. Cause diminished consciousness and giddiness. May occur up to 12 hours after procedure. Can be prevented by costly intravenous albumin (major protein found in blood - manufactured by liver)

International normalized ratio (INR)

measure of how long it takes for blood to clot compared to an average. Value <1.4 normal.

embyronal cell carcinoma

most aggressive type of primary scrotal malignancy (Elevated serum alpha fetoprotein and (hCG) levels are detectable in 70% of cases)

fibrocystic breast disease

most common abnormality of the breast.

adenoma

most common adrenal tumour.

leiomyoma

most common benign bladder mass. Well-defined, round or oval, solid mass. (cystic degeneration may occur) Found near bladder trigone

fibroadenoma

most common benign mass in premenoupausal women. UOQ. measure <3cm, homogenous with low-level internal echoes - possible cystic necrosis

Pleomorphic Adenomas

most common benign salivary gland tumor in childhood

cavernous hemangioma

most common benign tumor of the liver.

invasive ductal carcinoma

most common breast cancer - peak age 50. Palpable hard fixed mass UOQ. Focal breast tenderness and nipple discharge. Originates in lactiferous ducts. Sono: hypo, speculated mass with finger like extensions into dilated ducts. Posterior shadowing and tall rather than wide.

prostate cancer

most common cancer affecting north american men. (is second only to lung cancer as a cause of cancer-related death. )

epididymitis and epididymo-orchitis

most common cause of acute scrotal pain

alcohol abuse

most common cause of chronic pancreatitis

mumps

most common cause of parotitis.

hydrocele

most common cause of scrotal swelling

portal hypertension

most common cause of splenomegaly.

duplex collecting system

most common congenital anomaly of the urinary tract.

renal artery stenosis

most common correctable cause of hypertension

parathyroid adenoma

most common finding in the parathyroid.

hypercalcemia

most common indication for parathyroid ultrasound.

head

most common location of pancreatic neoplasms.

transitional cell carcinoma

most common malignant bladder tumor. Symptoms include: Hematuria, frequency, dysuria and suprapubic pain Common in men(3:1) in 6th and 7th decade

splenic hemangioma

most common primary benign neoplasm of the spleen.

prostate, lung, malignant melanoma, colon, kidney.

most common primary tumor to metastasize to the testis are

papillary cancer (78%)

most common thyroid malignancy. 20-50 yrs, more common in women than men. Painless, palpable nodule, with or without cervical lymph node involvement.

Renal cell carcinoma

most common type of malignant renal tumor and accounts for more than 90% of all renal tumours. More common in men.

spleen

most frequently injured visceral organ in patients with blunt abdominal trauma.

ALT

most sensitive indicator of hepatocellular disease

<2

normal RAR

11cm long, 2.5cm thick, and 5cm wide.

normal adult kidney measurement

<3mm

normal breast skin tissue thickness

1.0cm

normal renal cortex measures a minimum of

primary hyperparathyroidism

one of the most common endocrine disorders

spleen

organ that is frequently involve din patients with lymphoma

stenson's duct

parotid gland's duct which exits above the second molar approx 1cm below the zygomatic arch

squamous cell carcinoma

rare but second most common urothelial tumour of bladder. Large, solid flat ,and infilitrating lesions with extensive ulceration

adrenocortical cancer

rare, but most common primary tumour of adrenal gland.

RAR greater than 3.5 and PSV greater than 180cm/s

renal artery stenosis criteria for RAR and PSV

focal nodular hyperplasia

second most common benign liver mass.

solitary nodule, hypoechoic, punctate calcifications, irregular surrounding halo, tall>wide, irregular margins, central vascularity, enlargement of a nodule, calcs in a solitary nodule in a person <40.

sonographic signs of malignancy in thyroid nodules.

wharton's duct

the excretory duct for the submandibular gland, extends along the mylohyoid and medial part of the sublingual gland to its orifice on the floor of the mouth.

diabetes mellitus

the most common cause of chronic renal failure?

adenomatoid tumor

the most common extra testicular neoplasm, and most common tumour of the epididymis, and occur more often in the lower pole

seminomas

the most common intratesticular malignancy

hepatoblastoma

the most common primary malignant liver tumour in children under four years of age who usually present with painless abdominal mass and raised AFP. It is tumour of embryonic origin. Appear as predominantly echogenic soft tissue mass. In larger tumours heterogeneity and variable echogenicity is common.

terminal ductal lobular unit (TDLU)

the origin of most breast pathology

partial thromoblastin time

times your blood's ability to clot. 25- 35 seconds.

TB and histoplasmosis

two most common causes of adrenal calcification in the adult population.

12cm in girls and 13 cm for boys

upper limit of normal splenic length

1.3cm

upper limits of normal for portal vein measurement

cirrhosis

waveform in hepatic vein will be monophasic and blunted in what liver condition?

graves disease

what is the common cause of hyperthyroidism?

renal transplant rejection, inflammation, obstruction

when this happens there will an abnormal RI >0.8. There will be reduced possibly even reversed diastolic flow from mid pole segmental artery.

benign breast characteristics

wider than tall Ellipsoid Through transmission Smooth walled Macro-lobulation

other breast, bone, lung, liver

• Metastatic breast cancer (Stage IV) most advanced, generally spreads to (in order):

malignant melanoma, lung, cervix, bladder, lymphoma, ovary

• Mets to the breast (as a secondary) Is uncommon, from :

BIRADS

0 - incomplete evaluation 1 - normal 2 - benign (cysts, FA, etc) 3 - probably benign - less than 2% chance of malignancy 4 - suspicious 5 - most certainly malignancy 6 - biopsy proven malignancy

malignant breast characteristics

Marked hypoechogenicity Spiculation or irregular margins Taller than wide Angular margins Shadowing Microlobulation (1-2mm) Duct extension Calcifications Branch pattern

pancreatic ductal adenocarcinoma

- is the most common primary pancreatic neoplasm (85-95%) - 60-80 yr old males - Most lethal malignancy

Ducts of Rivinis

10 small ducts that drain the sublingual gland.

Invasive Lobular Carcinoma:

2nd most common breast cancer. Peak age 55-70. Diffusely infiltrating, multifocal, multicentric, bilateral. Area of breast thickening and focal breast tenderness. Sono: infiltrating, irregular border, hypoechoic with shadowing.

germ cell cancers

90% of cancers of the testicle are what type of cancers?

common causes of ascites

CHRONIC Liver disease Renal disease Cancer ACUTE Trauma Perforated ulcer Appendicitis Inflammation of colon Abdominal surgery

TSH

First line test for assessment of thyroid function. High levels are found in primary hypothyroidism Suppressed levels are found in hyperthyroidism

mixed germ cell tumour

Most common NSGCT, second most common primary testicular malignancy after seminoma

thyroglossal duct cyst

Most common congenital anomaly that develops within the remnant of the thyroglossal duct, which courses from the base of the tongue to the supra-sternal region.

nephroblastoma (willms tumor)

Most common intra-abdominal malignant tumour in children Peak ages 2-5 yrs old Usually bulky and expands within the renal parenchyma If large, results in distortion of the sinus, pyramids, cortex, and contour of the kidney

hypoechoic

Most intratesticular malignant masses are hypo or hyperechoic when compared with normal testicular tissue?

caroli's disease

Rare and congenital, non-obstructive segmental dilation of intrahepatic ducts.