8. Neoplasms of the Kidney Flashcards
What is chronic renal failure?
Reduced nephron numbers causes increased glomerular pressure in remaining
Results in progressive glomerulosclerosis
What are the clinical signs of chronic renal failure?
Uraemia
Small, scarred kidneys
Hypertension and hypertrophy due to RAAS
Acute fibrinous pericarditis
What are the benign tumours of the kidney?
Angiomyolipoma
Oncocytoma
What cells do angiomyolipomas originate in?
Perivascular epitheloid cells
What cells do oncocytomas originate in?
Collecting ducts
What are the malignant tumours of the kidney?
Nephroblastoma (children)
Urothelial cell carcinoma
Renal cell carcinoma
What cells do urothelial cell carcinomas originate in?
Pelvic calices
What cells do renal cell carcinomas originate in?
Tubular epithelial cells
What investigations can be done into a suspected kidney tumour?
Ultrasound
CT
Biopsy not done usually
What reasons might a biopsy be done in a kidney tumour?
Single kidney
Possibility of not being RCC
If the patient is suitable for a partial nephrectomy
What are the risk factors for renal cell carcinoma?
70s , male
Smoking, obesity, cystic lesions
Genes on chromosome 3
What is the gross appearance of a renal cell carcinoma?
Yellow with haemorrhage and necrosis
Cystic
What is the most common microscopic appearance of a renal cell carcinoma?
Clear cell
Adenocarcinoma but doesn’t produce mucin
Often invades renal vein which gives a poor prognosis
Name 2 other types of renal cell carcinoma
Papillary
Chromophobe
What are the genetic predispositions to papillary renal cell carcinomas?
Chromosome 7 or 17 trisomy
Loss of Y chromosome
What is the cell of origin of a chromophobe renal cell carcinoma?
Intercalated cells
Why do urothelial carcinomas require follow up?
Associated with tumours elsewhere in the urinary tract
What is the most common type of cancer in the bladder?
Urothelial carcinoma
What are the risk factors for urothelial carcinomas in the bladder?
Anniline dyes
Organic chemicals
Smoking
What factors are associated with squamous cell carcinoma of the bladder?
Schistosomiasis
Long standing catheters
What factor is associated with adenocarcinomas in the bladder?
Fistulas with the bowel
What paraneoplastic syndromes are associated with RCC?
Polycythaemia
Hypercalcaemia
Hypertension
PUO
Classify kidney disease in SLE
- Positive on fluorescent microscopy
- mesangial proliferation
- Segmental lesions <50% of glomerulus
- > 50% glomerulus
- Membranous pattern
What can be seen microscopically in SLE kidney disease?
All immunoglobulins positive
Deposits in all components of glomerulus
Segmental glomerular acute inflammation
Large subendothelial deposits
