cancers of the urinary tract Flashcards
what is the gleason score used for
grading prostate cancer histologically
when is MRI used in prostate cancer
- pre-biopsy
- local staging
- guide targeted biopsy
what zone of the prostate does BPH occur in
transitional zone -> groove becomes deeper
when should bone scanning be done (prostate cancer)
if PSA >20ng/mL -> look for mets
what bone abnormality may be seen on bones in prostate cancer
all uniformly sclerotic
what cancers are the top primaries to metastasize to bone
- breast (if bone sclerosis seen in F assume this is the primary)
- prostate (if bone sclerosis seen in M assume this is the primary)
- lung
- kidney
what appears bright on T1 MRI (2)
- blood
- fat
what appears bright on T2 MRI
fluid e.g. CSF
how will normal vertebrae appear on T1 imagine (bright or dark)
bright - they are fatty so appear bright on T1 imaging
where is an RCC likely to spread to and why
the renal vein -> it is a highly vascular tumour
RCC appearance on imaging
- central hypoattenuation
- irregular
- heterogenous
- exophytic
where do RCCs commonly metastasize to (3)
lung, bone, liver
if a lytic bone lesion is seen on imaging, what are the primary/secondary malignancies likely to be
primary - osetosarcoma
secondary - breast, lung, kidney
prostate is usually sclerotic not lytic!!!
what might a solitary lytic bone lesion indicate
plamacytoma - a tumor of plasma cells of bony or soft tissue
are kidney mets common
no - they kidneys are one of the last places to metastasise to
what benign tumour is easily confused with RCC on imaging
oncocytoma - they are usually removed to be safe
2 benign renal tumours
- angiomyolipoma
- oncocytoma
4 malignant renal tumours
- renal cell carcinoma
- transitional cell carcioma
- wilms tumour
- lymphoma
what is tubulosclerosis
a rare genetic condition that causes mainly benign tumours to develop in different parts of the body
-> predisposes a person to angiomyelomas in kidneys, they can bleed drastically but are otherwise benign
what is the commonest location for a TCC
bladder
2 initial imaging investigations for haematuria
- US urinary tract
- cystoscopy
3 methods of upper urinary tract imaging
- IV urogram
- CT urogram
- uteroscopy
if a dark outline surrounding a bladder tumour can be seen on imaging, what does this indicate about the tumour
is it confined to muscle
what imaging modality is used to image testicular cancer
ultrasound
