110314 tumors

Question 1

Which polycystic kidney disease has cortical based cysts?

Answer 1

adult form-autosomal dominant

Question 2

symptoms of renal cell carcinoma

Answer 2

painless hematuria, palpable abd mass, dull flank pain = classic triad

polycythemia in 5-10% of cases

Question 3

types of renal cell carcinoma ex in order of prevalance

Answer 3

clear cell
papillary
chromophobe
collecting duct (a subtype is medullary carcinoma)

Question 4

what renal cell carcinoma has the worst outcome?

Answer 4

collecting duct tumor

Question 5

what renal cell carcinoma has the best outcome?

Answer 5

chromophobe

Question 6

renal oncocytoma

Answer 6

benign tumor

Question 7

angiomyolipoma

Answer 7

non-epithelial tumor. from stroma.
contains vessels, sm musc, fat
most frequent benign renal tumor

Question 8

histology of papillary type of renal cell carcinoma

Answer 8

tumor cells with stromal core (core contains vessels and macrophages)

Question 9

histology of chromophobe carcinoma

Answer 9

halo around wrinkled nucleus

binucleate cells

Question 10

medullary carcinoma

Answer 10

restricted to individuals of African or Mediterranean descent

pts have sickle cell dis or trait

presents at very high stage, resists chemo. worst outcome of all kidney cancers

Question 11

in what do you see lots of vacuoles and oxalate crystals on histology?

Answer 11

acquired cystic disease asscoiated renal carcinoma

Question 12

what tumor is derived from cells that have premelanosomes

Answer 12

angiomyolipoma

Question 13

Wilm’s tumor

Answer 13

almost always pediatric tumor

variety of cell and tissue components derived from mesoderm

Question 14

acquired non-neoplastic anomalies of urinary bladder

Answer 14

cystitis cystica/cystitis glandularis
polypoid and papillary cystitis
nephrogenic adenoma

all of these may mimic a tumor

Question 15

how do polypoid and papillary cystitis arise?

Answer 15

catheter, stone, etc

in the setting of submucosal edema, usually w inflam

Question 16

how to distinguish polypoid cystitis from papillary cystitis?

Answer 16

poplypoid has a tip that is wider than base

Question 17

nephrogenic adenoma

Answer 17

also called nephrogenic metaplasia

males 2:1
60% of cases are following GU surgery
often associated w chronic cystitis
benign proliferaiton of tubules

Question 18

bladder cancer may be what two forms

Answer 18

flat or take the form of a mass

when takes the form of a mass, called papillary or exophytic

Question 19

key determination to make for staging bladder cancer

Answer 19

whether muscularis propria is invaded–leads to conservative management vs cystectomy

Question 20

in high grade urothelial carcinoma, what histologically do you expect to see?

Answer 20

huge nuclei, jumbled polarity

Question 21

flat lesions in bladder–ex in increasing grade

Answer 21

reactive
indeterminate
dysplasia
carcinoma in situ

Question 22

carcinoma in situ of bladder presents how

Answer 22

often with bladder ulcerations, mimicking some benign conditions

Question 23

upper urothelial tract urothelial carcinoma

Answer 23

renal pelvis and ureter
most cases are high grade
half are locally advanced (stage pT2 or higher)
in more aggressive cases-muscle wall is thin

Question 24

in order of increasing grade, ex of papillary bladder lesions?

Answer 24

papilloma
papillary neoplasm of uncertain potential
low grade urothelial cancer
high grade urothelial cancer