Liver Pathology (Malignant Solid Hepatic Lesions & Other Primary Liver Tumors)

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| By Geekee68
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Geekee68
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Quizzes Created: 19 | Total Attempts: 6,980
Questions: 39 | Attempts: 142

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Liver Pathology (Malignant Solid Hepatic Lesions & Other Primary Liver Tumors) - Quiz

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Questions and Answers
  • 1. 

    What is the "most common" malignant liver tumor in children?

    Explanation
    Hepatoblastoma is the most common malignant liver tumor in children. It is a rare cancer that primarily affects children under the age of 3. Hepatoblastoma usually starts in the liver cells and can spread to other parts of the body. It is characterized by the rapid growth of abnormal cells in the liver. Early detection and treatment are crucial for a better prognosis. Treatment options for hepatoblastoma may include surgery, chemotherapy, and radiation therapy.

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  • 2. 

    Hepatoblastoma is a secondary cancer in adults with an increased incidence in females.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    It is "primary" in "children" with increased incidence in "males".

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  • 3. 

    Hepatoblastoma has an increased incidence in patients with ___________ - ___________ Syndrome.

    Correct Answer
    Beckwith-Wiedemann
    Beckwith Wiedemann
    Explanation
    Hepatoblastoma, a rare liver cancer primarily affecting children, is known to have a higher occurrence in patients with Beckwith-Wiedemann Syndrome. Beckwith-Wiedemann Syndrome is a genetic disorder characterized by overgrowth and an increased risk of tumor development. This syndrome is caused by various genetic abnormalities, including changes in specific genes that regulate growth and development. The association between hepatoblastoma and Beckwith-Wiedemann Syndrome suggests a potential link between the genetic alterations involved in both conditions.

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  • 4. 

    Beckwith-Wiedemann Syndrome is a rare, overgrowth disorder in which babies are __________ at birth and may develop _________  _________  _________.

    Correct Answer
    large, low blood sugar
    Explanation
    Beckwith-Wiedemann Syndrome is a rare, overgrowth disorder in which babies are born larger than average and may develop low blood sugar. This syndrome is characterized by excessive growth, particularly in the body and organs. The condition can also lead to other complications such as abdominal wall defects, large tongue, and visceromegaly. The low blood sugar, or hypoglycemia, is a common feature of this syndrome and can cause symptoms such as shakiness, irritability, and difficulty feeding.

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  • 5. 

    Beckwith-Wiedemann Syndrome increases the risk of developing certain cancers, especially __________ tumor.

    Correct Answer
    Wilm's
    Explanation
    Beckwith-Wiedemann Syndrome is a genetic disorder that causes various abnormalities and increases the risk of developing certain types of cancers. One of the most commonly associated tumors with this syndrome is Wilm's tumor, a type of kidney cancer that primarily affects children. This tumor arises from the cells that form the kidneys during fetal development. Therefore, individuals with Beckwith-Wiedemann Syndrome have an increased likelihood of developing Wilm's tumor compared to the general population.

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  • 6. 

    Hepatoblastoma - Clinical and Lab Data:Check all of the following that apply.

    • A.

      Abdominal enlargement

    • B.

      Hepatomegaly

    • C.

      Weight loss

    • D.

      Nausea and vomiting

    • E.

      Markedly elevated AFP

    • F.

      Fever

    Correct Answer(s)
    A. Abdominal enlargement
    B. Hepatomegaly
    C. Weight loss
    D. Nausea and vomiting
    E. Markedly elevated AFP
    Explanation
    The correct answer is Abdominal enlargement, Hepatomegaly, Weight loss, Nausea and vomiting, Markedly elevated AFP. Hepatoblastoma is a rare type of liver cancer that primarily affects children. The clinical and lab data associated with hepatoblastoma include abdominal enlargement, hepatomegaly (enlarged liver), weight loss, nausea and vomiting, and markedly elevated AFP (alpha-fetoprotein) levels. These symptoms and lab findings are commonly observed in patients with hepatoblastoma and can help in the diagnosis and management of the disease.

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  • 7. 

    Hepatoblastoma - Sono Appearance:Check all of the following that apply.

    • A.

      May be hyperechoic or cystic with septations

    • B.

      May be hypoechoic or cystic with septations

    • C.

      Often heterogeneous

    • D.

      Occasionally has calcifications

    • E.

      Often homogeneous

    Correct Answer(s)
    A. May be hyperechoic or cystic with septations
    C. Often heterogeneous
    D. Occasionally has calcifications
    Explanation
    Hepatoblastoma is a type of liver cancer that primarily affects children. The sonographic appearance of hepatoblastoma can vary, but it may be hyperechoic or cystic with septations. This means that on the ultrasound image, the tumor may appear brighter than the surrounding liver tissue or contain fluid-filled areas with dividing walls. Additionally, hepatoblastoma often appears heterogeneous, meaning that it has areas of different echogenicity or texture. Occasionally, calcifications can also be seen within the tumor.

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  • 8. 

    Hepatoblastoma:Prognosis is _________ if the tumor is __________ and can be completely removed by surgery.

    Correct Answer(s)
    good, small
    Explanation
    If the hepatoblastoma tumor is small and can be completely removed by surgery, the prognosis is good. This means that the chances of recovery and survival are high. The size and complete removal of the tumor are important factors in determining the prognosis of hepatoblastoma.

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  • 9. 

    HCC (Hepatocellular Carcinoma), also known as ___________, is a ___________ (primary or secondary?) liver cancer.  This is one of the "most common" malignant tumors.

    Correct Answer(s)
    hepatoma, primary
    Explanation
    HCC, also known as hepatocellular carcinoma, is a primary liver cancer. Hepatoma is another term used to refer to HCC. HCC is considered one of the most common malignant tumors, indicating its high prevalence.

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  • 10. 

    ____________ is the most common predisposing factor (80% of cases) in North America for Hepatocellular Carcinoma.

    Correct Answer(s)
    Cirrhosis
    Explanation
    Cirrhosis is the most common predisposing factor for Hepatocellular Carcinoma in North America, accounting for 80% of cases. Cirrhosis is a condition characterized by the scarring of the liver tissue, often caused by chronic liver diseases such as hepatitis B or C, alcohol abuse, or fatty liver disease. The scarring disrupts the normal functioning of the liver and increases the risk of developing liver cancer. Therefore, individuals with cirrhosis are more likely to develop Hepatocellular Carcinoma compared to those without this condition.

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  • 11. 

    Chronic hepatitis B can lead to the development of HCC.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Chronic hepatitis B is a long-term infection caused by the hepatitis B virus. If left untreated, it can cause inflammation and damage to the liver, which increases the risk of developing hepatocellular carcinoma (HCC), the most common type of liver cancer. Therefore, it is true that chronic hepatitis B can lead to the development of HCC.

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  • 12. 

    Hepatocellular Carcinoma - Clinical and Lab Data:Check all the following that apply.

    • A.

      Palpable mass

    • B.

      Rapid liver enlargement

    • C.

      Unexplained mild fever

    • D.

      Unexplained high fever

    • E.

      Weight loss

    • F.

      RLQ pain

    • G.

      RUQ pain

    • H.

      Signs and symptoms associated with cirrhosis

    • I.

      LFT's may be normal

    • J.

      Increased AFP

    Correct Answer(s)
    A. Palpable mass
    B. Rapid liver enlargement
    C. Unexplained mild fever
    E. Weight loss
    G. RUQ pain
    H. Signs and symptoms associated with cirrhosis
    I. LFT's may be normal
    J. Increased AFP
    Explanation
    The correct answer includes the following signs and symptoms that are commonly associated with Hepatocellular Carcinoma: palpable mass, rapid liver enlargement, unexplained mild fever, weight loss, RUQ pain, signs and symptoms associated with cirrhosis, LFT's may be normal, and increased AFP. These findings are indicative of a liver tumor, with the presence of a palpable mass and rapid liver enlargement suggesting the presence of a large tumor. Unexplained fever and weight loss are common systemic symptoms seen in cancer patients. RUQ pain and signs and symptoms associated with cirrhosis may be present due to the underlying liver disease. LFT's may be normal due to the tumor being localized and not affecting liver function. Increased AFP is a tumor marker commonly seen in hepatocellular carcinoma.

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  • 13. 

    Hepatocellular Carcinoma - Sono Appearance:Appearance is varied.  May be a ___________ tumor, multiple ___________, or ___________ liver parenchyma invasion.

    Correct Answer(s)
    solitary, nodules, diffuse
    single, nodules, diffuse
    Explanation
    Hepatocellular Carcinoma can have a varied appearance on ultrasound. It may present as a solitary tumor, multiple nodules, or diffuse invasion of the liver parenchyma.

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  • 14. 

    Hepatocellular Carcinoma - Sono Appearance:Small masses (<5 cm) tend to be ____________ (hyperechoic or hypoechoic?).

    Correct Answer(s)
    hypoechoic
    Explanation
    Small masses (

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  • 15. 

    Hepatocellular Carcinoma - Sono Appearance:Larger lesions may be ____________ with areas of ____________.

    Correct Answer(s)
    complex, necrosis
    Explanation
    Larger lesions of Hepatocellular Carcinoma may appear complex, meaning they have irregular or mixed echogenicity patterns. These lesions can also show areas of necrosis, which refers to the death of cells within the tumor. The presence of complex echogenicity and necrotic areas can help in the diagnosis and characterization of Hepatocellular Carcinoma.

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  • 16. 

    Hepatomegaly and ascites would be observed on sono in a patient with hepatocellular carcinoma.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    Yes, there is rapid liver enlargement.

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  • 17. 

    Hepatocellular Carcinoma - Sono Appearance:Portal veins, hepatic veins and bile duct invasion are rarely seen in patients with HCC.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    The statement is false because portal veins, hepatic veins, and bile duct invasion are commonly seen in patients with Hepatocellular Carcinoma (HCC). These invasive features are important diagnostic criteria for HCC and can be detected using ultrasound imaging.

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  • 18. 

    One of the complications of HCC is that it tends to invade the ___________ veins producing ___________  ____________ Syndrome.

    Correct Answer
    hepatic, Budd Chiari
    Explanation
    Hepatocellular carcinoma (HCC) is a type of liver cancer that can invade the hepatic veins, which are responsible for draining blood from the liver. When HCC invades these veins, it can lead to a condition known as Budd-Chiari syndrome. Budd-Chiari syndrome occurs when there is obstruction or blockage of the hepatic veins, leading to liver congestion, liver enlargement, and impaired liver function. This can cause symptoms such as abdominal pain, ascites (accumulation of fluid in the abdomen), and liver failure. Therefore, the correct answer is hepatic, Budd-Chiari.

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  • 19. 

    ___________ or ___________ invasion of the portal system is seen in ___(#) to ___(#)% of HCC patients.

    Correct Answer
    thrombus, tumor, 30, 60
    Explanation
    In hepatocellular carcinoma (HCC) patients, the presence of thrombus or tumor invasion in the portal system is observed in 30% to 60% of cases. This means that a significant proportion of HCC patients experience either thrombus formation or tumor invasion in their portal system, which can have implications for their prognosis and treatment options.

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  • 20. 

    Hepatocellular Carcinoma - Complications:Besides invading the hepatic and portal veins, HCC may also invade the ___________  ___________.

    Correct Answer
    biliary tree
    Explanation
    Hepatocellular Carcinoma (HCC) is a type of liver cancer that can invade not only the hepatic and portal veins but also the biliary tree. The biliary tree consists of the bile ducts, which carry bile from the liver to the gallbladder and small intestine. When HCC invades the biliary tree, it can cause obstruction and lead to complications such as jaundice, cholangitis (inflammation of the bile ducts), and liver failure. Therefore, it is important to monitor for biliary tree invasion in patients with HCC to ensure timely management and prevent further complications.

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  • 21. 

    Metastatic liver disease is considered to be primary or secondary?

    Correct Answer
    secondary
    Explanation
    Metastatic liver disease is considered to be secondary. This means that it is not the primary disease that originated in the liver, but rather a result of cancer cells spreading to the liver from another part of the body. Primary liver cancer, on the other hand, originates in the liver itself. Therefore, metastatic liver disease is classified as secondary.

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  • 22. 

    Metastatic liver disease is ___(#) to ___(#) times more common than HCC.

    Correct Answer
    18, 20
    18 20
    18-20
    Explanation
    Metastatic liver disease is known to be more common than hepatocellular carcinoma (HCC), with the prevalence being 18 to 20 times higher.

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  • 23. 

    The liver is the most common site for metastatic development.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The liver is the most common site for metastatic development because it receives a large amount of blood flow from various organs, making it a favorable environment for cancer cells to spread and establish secondary tumors. Additionally, the liver has a rich network of blood vessels and immune cells that can facilitate the growth and survival of metastatic cells. As a result, many types of cancer, such as colorectal, breast, and lung cancer, frequently metastasize to the liver.

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  • 24. 

    Metastatic liver disease most often occurs from dissemination of tumor cells to the liver via the _________  vein, __________, __________  __________, and less common from direct extension.

    Correct Answer
    portal, lymphatics, hepatic artery
    Explanation
    Metastatic liver disease typically occurs when tumor cells spread to the liver through the portal vein, lymphatics, and hepatic artery. The portal vein is the most common route for tumor cells to reach the liver as it carries blood from the digestive organs directly to the liver. The lymphatics, which are a network of vessels that transport lymph fluid, can also serve as a pathway for tumor cells to reach the liver. Additionally, tumor cells can enter the liver through the hepatic artery, although this is less common compared to the portal vein and lymphatics.

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  • 25. 

    Usually the primary site for metastatic liver disease is GI related.

    • A.

      True

    • B.

      False

    Correct Answer
    A. True
    Explanation
    The statement is true because the liver is a common site for metastasis, especially in cases of gastrointestinal (GI) cancers. This is because the liver receives a large amount of blood supply from the GI tract, making it more susceptible to metastatic spread from GI tumors. Additionally, the liver has a rich network of blood vessels and immune cells, which can facilitate the growth and spread of cancer cells. Therefore, when cancer cells break away from a primary GI tumor, they are more likely to travel to the liver and form metastatic lesions.

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  • 26. 

    Metastatic Liver Disease:Check all the following that apply.

    • A.

      Abnormal LFT's

    • B.

      Normal LFT's

    • C.

      Hepatomegaly

    • D.

      Liver is atrophied

    • E.

      Elevated ALP and bilirubin

    • F.

      RUQ pain

    • G.

      Jaundice

    Correct Answer(s)
    A. Abnormal LFT's
    C. Hepatomegaly
    E. Elevated ALP and bilirubin
    F. RUQ pain
    G. Jaundice
    Explanation
    The correct answer is Abnormal LFT's, Hepatomegaly, Elevated ALP and bilirubin, RUQ pain, Jaundice. In metastatic liver disease, abnormal liver function tests (LFT's) can be seen due to impaired liver function. Hepatomegaly, or enlargement of the liver, is a common finding in metastatic liver disease. Elevated alkaline phosphatase (ALP) and bilirubin levels can occur due to liver dysfunction. RUQ pain, or pain in the right upper quadrant of the abdomen, can be present due to liver enlargement or inflammation. Jaundice, or yellowing of the skin and eyes, can occur due to impaired liver function and increased bilirubin levels.

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  • 27. 

    Metastatic Liver Disease - Sono Appearance:-Varied-Sonographically lack specificity for correlating the sonographic appearance of the hepatic metastases with the organ or cell type of origin.  However, some tendencies do exist.Match up the following:Hyperechoic Masses: ____Hypoechoic Masses: ____Cystic Masses: ____Target-like Masses: ____Calcified Masses: ____a) bronchiogenic cancer,  b) from lymphoma,  c) from colon ca, breast ca or hepatocellular, d)  mucinous adenocarcinoma of the colon,  e) leiomyosarcomas or mucinous ovarian ca

    Correct Answer(s)
    c, b, e, a, d
    cbead
    Explanation
    The correct answer is c, b, e, a, d. Hyperechoic masses are more commonly seen in metastatic liver disease from colon cancer, breast cancer, or hepatocellular carcinoma. Hypoechoic masses are often associated with lymphoma. Cystic masses are seen in leiomyosarcomas or mucinous ovarian cancer. Target-like masses are typically seen in bronchiogenic cancer. Calcified masses are associated with mucinous adenocarcinoma of the colon.

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  • 28. 

    Metastatic Liver Disease:____________  ____________  ____________ biopsies are performed to establish primary cell type.

    Correct Answer(s)
    ultrasound guided needle
    Explanation
    Ultrasound guided needle biopsies are performed to establish the primary cell type in cases of metastatic liver disease. This procedure involves using ultrasound imaging to guide the placement of a needle into the liver, allowing for a targeted biopsy of the suspicious area. By obtaining a sample of the liver tissue, pathologists can analyze it under a microscope to determine the type of cells present and identify the primary source of the metastasis. This information is crucial for determining the appropriate treatment plan for the patient.

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  • 29. 

    Metastatic Liver Disease:Ultrasound is also useful in monitoring _________ and __________ of the mass.

    Correct Answer(s)
    size, appearance
    Explanation
    Ultrasound is a useful tool in monitoring metastatic liver disease as it can provide information about the size and appearance of the mass. By measuring the size of the mass, healthcare professionals can track its growth or regression over time. Additionally, ultrasound can help assess the appearance of the mass, such as its shape, texture, and internal characteristics. This information can be crucial in determining the nature of the mass and guiding treatment decisions.

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  • 30. 

    Benign vascular mesenchymal tumors that present in infancy (usually before 6 months old) is called a _________________.

    Correct Answer(s)
    hemangioendothelioma
    Explanation
    A benign vascular mesenchymal tumor that presents in infancy, usually before 6 months old, is called a hemangioendothelioma.

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  • 31. 

    What is the name of the most common symptomatic vascular tumor in infancy and is more common in females?

    Correct Answer(s)
    hemangioendothelioma
    Explanation
    Hemangioendothelioma is the name of the most common symptomatic vascular tumor in infancy and it is more common in females.

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  • 32. 

    Hemangioendothelioma - Clinical and Lab Data:Check all of the following that apply.

    • A.

      CHF

    • B.

      Abdominal mass

    • C.

      Hepatomegaly

    • D.

      Normal AFP levels

    Correct Answer(s)
    A. CHF
    B. Abdominal mass
    C. Hepatomegaly
    D. Normal AFP levels
    Explanation
    Normal AFP levels excludes the possibility of hepatoblastoma.

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  • 33. 

    Hemangioendothelioma is more common in males.

    • A.

      True

    • B.

      False

    Correct Answer
    B. False
    Explanation
    more common in females

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  • 34. 

    Hemangioendothelioma - Sono Appearance:Check all that apply.

    • A.

      Hyperechoic

    • B.

      Hypoechoic

    • C.

      Complex

    • D.

      Cystic spaces representing highly vascular lesion or cystic necrosis

    Correct Answer(s)
    A. Hyperechoic
    B. Hypoechoic
    C. Complex
    D. Cystic spaces representing highly vascular lesion or cystic necrosis
    Explanation
    The correct answer is Hyperechoic, Hypoechoic, Complex, Cystic spaces representing highly vascular lesion or cystic necrosis. Hemangioendothelioma can have a variety of ultrasound appearances. It can appear hyperechoic, meaning it appears brighter than the surrounding tissue, or hypoechoic, meaning it appears darker than the surrounding tissue. It can also appear complex, meaning it has a mixture of echogenicity, or have cystic spaces representing highly vascular lesion or cystic necrosis. These ultrasound findings can help in the diagnosis of hemangioendothelioma.

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  • 35. 

    Complications of hemangioendothelioma:Check all that apply.

    • A.

      Thrombocytopenia

    • B.

      Anemia

    • C.

      GI Bleeding

    • D.

      Intra-abdominal hemorrhage with rupture

    Correct Answer(s)
    A. Thrombocytopenia
    B. Anemia
    C. GI Bleeding
    D. Intra-abdominal hemorrhage with rupture
    Explanation
    Hemangioendothelioma is a rare type of tumor that arises from the cells lining blood vessels. Complications of hemangioendothelioma can include thrombocytopenia, which is a decrease in platelet count leading to an increased risk of bleeding. Anemia, a condition characterized by a decrease in red blood cell count, can also occur. GI bleeding, referring to bleeding in the gastrointestinal tract, is another potential complication. Intra-abdominal hemorrhage with rupture can happen if the tumor grows and causes the blood vessels to rupture, leading to significant bleeding within the abdomen.

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  • 36. 

    What is the malignant counterpart to hemangioendothelioma called?

    Correct Answer(s)
    hemangioendotheliosarcoma
    Explanation
    Hemangioendotheliosarcoma is the correct answer because it is the malignant counterpart to hemangioendothelioma. Hemangioendothelioma is a rare vascular tumor that can be either benign or malignant. In the case of malignancy, it is referred to as hemangioendotheliosarcoma. This term indicates that the tumor has transformed into a sarcoma, which is a type of cancer that arises from connective tissues such as bone, muscle, or blood vessels. Therefore, hemangioendotheliosarcoma is the appropriate name for the malignant form of hemangioendothelioma.

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  • 37. 

    ___________  ___________ is seen in patients with acquired immunodeficiency syndrome (AIDS) and is rarely diagnosed during life.  However, it is seen in 34% of autopsy studies in these patients.

    Correct Answer(s)
    Kaposi's Sarcoma
    Explanation
    Kaposi's Sarcoma is a type of cancer that is commonly seen in patients with AIDS. It is rarely diagnosed during life, meaning that it is often only discovered during autopsy studies. This cancer is characterized by the development of abnormal blood vessels in the skin, mucous membranes, and other organs. It can cause lesions or tumors that may be red, purple, or brown in color. The high prevalence of Kaposi's Sarcoma in AIDS patients highlights the impact of immunodeficiency on the development of this cancer.

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  • 38. 

    Sonographically, Kaposi's sarcoma produces __________, small (5-12mm) __________ (hyperechoic or hypoechoic?) nodules, and dense __________ bands may be seen within the liver.

    Correct Answer(s)
    multiple, hyperechoic, periportal
    Explanation
    Kaposi's sarcoma is a type of cancer that can be detected through sonography. It typically appears as multiple small nodules, ranging from 5-12mm in size. These nodules are described as hyperechoic, meaning they produce a strong echo on the ultrasound image. Additionally, dense periportal bands may be observed within the liver.

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  • 39. 

    Patients with small HCC lesions (<4.5 cm) who are poor surgical risks may be treated with percutaneous injections of __________  ___________ into the lesion with ultrasound guidance.

    Correct Answer(s)
    ethyl alcohol
    Explanation
    Patients with small HCC lesions (

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