Chapter 14 Renal Pathology power point

Question 1

Angiomylolipoma- (hamartoma)

Cysts

Answer 1

Pathology – Benign

Question 2

a mass composed of fat, blood vessels and smooth muscle tissue
Highly echogenic , homogenous.

Answer 2

Angiomylolipoma- (hamartoma)

Question 3

simple,parapelvic,hemorrhagic,multicystic dysplastic,polycystic kidney disease, (autosomal recessive and autosomal dominant)

Answer 3

Cysts

Question 4

Most common renal mass
Spherical, smooth wall, anechoic, posterior acoustic enhancement
Normally asymptomatic, unless they become large and compress adjacent renal tissue
Clinically insignificant
50% of the population > age 50 have these

Answer 4

Simple renal cyst

Question 5

cyst projects outward away from the kidney

Answer 5

Exophytic

Question 6

cyst lies within the renal cortex

Answer 6

Cortical

Question 7

cyst that originates in the renal parenchyma and protrude into the renal sinus

Answer 7

Parapelvic

Question 8

cyst that originate in the renal sinus

Answer 8

Peripelvic

Question 9

A cyst that does not meet the diagnostic criteria of a simple cyst
Septations, internal debris, mural nodules, papillary projections, irregular borders are worrisome for malignancy and will be followed up with other imaging modalities or surgery
Renal cell carcinoma can manifest as a multicystic mass

Answer 9

Complex renal cysts

Question 10

Autosomal Dominant Polycystic Kidney Disease (ADPKD) also known as Adult Polycystic Disease (APKD)
Normally lies dormant for many years and manifests itself in the third to fourth decade (30-40 years of age)
Patient may also develop multiple cysts of varying sizes in other organs including pancreas, liver and spleen
40% associated with polycystic liver disease

Answer 10

Polycystic kidney disease

Question 11

Can be asymptomatic until third to fourth decade of life
Decreased renal function
UTI
Renal calculi
Flank pain
Hematuria 
Palpable abdominal mass

Answer 11

clinical findings of APKD

Question 12

Autosomal recessive (ARPKD)- relatively rare genetic disorder divided into four types depending on onset.

1. Perinatal-found in-utero, common leading factor for demise. Oligohydramnios and enlarged echogenic kidneys
2. Neonatal
3. Infantile
4. Juvenille

Answer 12

Polycystic kidney disease

Question 13

Often recognized in the fetus
Confirmed with a postnatal ultrasound
Perinatal death often occurs
Secondary complications of renal failure and hepatic disease often causes early death
Bilateral disease, loss of corticomedullary differentiation

Answer 13

arpkd

Question 14

Renal failure

Hepatic disease

Answer 14

Clinical findings of ARPKD

Question 15

a mass composed of fat, blood vessels and smooth muscle tissue
Highly echogenic , homogenous
Usually discovered incidentally
Unilateral
Patients with tuberous sclerosis have a tendancy to develop these, usually bilateral
Not painful unless there is hemorrhage within the mass

Answer 15

Angiomylolipoma- (hamartoma)

Question 16

Rare, benign
Caused by an accumulation of calcium in the renal parenchyma
Two forms, Medullary and Cortical
Medullary is congenital
Kidneys are small to normal in size with increased echogenicity in the renal pyramids that may shadow

Answer 16

Nephrocalcinosis/Medullary Sponge Kidney

Question 17

Hypercalcemia
Hyperparathyroidism
Urinary tract infection
History of urinary calculi

Answer 17

Cortical nephrocalcinosis may be caused by

Question 18

Benign
Often found in men in their 60’s
Stellate scar may be seen within mass
Scar most easily seen on CT scan
RCC also has scar
Difficult to distinguish from RCC and surgical excision is often done

Answer 18

oncocytoma

Question 19

renal cell carcinoma/ hypernephroma/adenocarcinoma of the kidney

Answer 19

Malignant renal masses

Question 20

Smoking
Hypertension
Obesity
Tuberous sclerosis
von Hippel-Lindau disease
Aquired renal cysts from long term dialysis

Answer 20

Malignant renal masses

Risk Factors

Question 21

Anorexia
Flank pain
Gross hematuria
Hypertension
Palpable mass
Weight loss

Answer 21

Malignant renal masses

Clinical Symptoms

Question 22

Often found in the renal pelvis
May also be found in the ureter and bladder
Can cause obstruction due to location

Answer 22

Transitional cell carcinoma TCC

Question 23

from the lungs or breast most common
prostate,pancreas and melanoma less frequently
RCC can also metastasize from the contralateral kidney

need to check invasion of tumor into the renal vein and IVC

Answer 23

metastases