Exam 2- Tumors Flashcards
What is the most common benignrenal cancer
renal papillary adnoma
What are the benign cancers of the kidneys
renal papillary adenoma, angiomyolipoma, oncocytoma, renal fibroma or hamartoma
juxtaglomerular cell tumor
mesenchymal tumores
What is the size of a benign ademoa
<1 cm
what are ademoas that are >1cm in diameter
low grade RCC
What is the gross appearance or papillary ademoas
cortical, discrete, yellow gray, small and there may be multiple of them
may have psammoma bodies
acidophilic cytoplasm
what genetic mutation is assoc with renal papillary ademoa
trisomy 7 and 17
What disease has 25-50% patients present with angiomyolipomas
tuberous sclerosis
What is tuberous sclerosis and what is mutation involved
TSC1 or 2 (tumor suppressor genes
autosomal dominant
tumores or lesions of brain(mental retardation), skin, kidney, hear, lungs and eyes
lisch nodules
Angiomyolipomas greatest risk factor is what
susceptible to spontaneous hemorrhage, massive retroperitoneal hemorrhage and shock
Where do oncocytomas arise from
type A intercalated cells of renal cortical collecting ducts
what is the morphology on oncocytomas
epithelial tumor with large eosinophilic cells, large round nuclei numerous mitochondria large tan or brown mahogany color. get grow to 12 cm stellate scar
What is the familial association with oncocytomas
familial 10 q deletion with multicentricity and b/l
What are oncocytomas confused with
RCC , non clear cell
What age gorup are oncocytomas Dx in
adults.
What is the population of tuberous sclerosis and renal angiomyolipoma
middle aged females
What is the most common adult renal malignant tumor
RCC
what population is RCC seen mostly in
60-80 yrs old male to femal 2:1 equal distribution racially
what does RCC arise from
renal tubular epithelium, adenocarcinoma
what are the risk factors assoc with RCC
SMOKING
HTN obesity, estrogens, asbestos, chronic renal disease, tuberous sclerosis, acquired cystic disease
What is the hereditary form of RCC
autosomal dominant
younger patients
VHL syndrome develop b/; hereditary clear cell carcinoma or hereditary papillary carcinoma
What is the most common type of RCC
clear cell
clear granular cytoplasm
non papillary
95% sporadic
what is the mutation seen with clear cell carcinoma familial
loss of sequences on short arm of chromosome 3. deletions or translocations
this is the VHL tumor supressor gene
What is Birt Hogg Dube syndrome and what type inheritance
folliculin gene mutation, autosomal dominant
skin pulmonary and renal tumors
What type of mutation is seen in papillary carcinoma
trisomy 7, 16,17 lost Y (MET oncogene)
A renal tumor has clear cytoplasm with papillary architecture in the medulla. and is Dx in a young patient. not clear cell or papillary. what is it?
Xp11 translocation carcinoma
collecting (bellini) duct carcinoma
What is the morphology of chromophobe renal carcinoma
pale eosinophilic cytoplasm, nuclear halos,
arise from type B intercalated cells of renal Cx collecting ducts
solid growth pattern
What does chromophobe renal carcinoma resemble
oncocytoma
where are papillary tumors clinically found
distal convoluted tubles
b/l
can invade renal vein, vena cava
What is the classic triat of RCC
hematuria (microscopic usually)
CVA pain
palpable flank mass
When RCC are Dx whats the main concern
already have metastasized
What are the begining symptoms of RCC
weight loss, malaise, weakness, fever
where does RCC metastasize to
lung, bone, regional nodes, liver, adrenal brain and unusual sites
Rank the types of RCC histologic types and associated prognostic value
papllary and chromophobe have better Px
clear cell is moderate
collecting duct, sarcamatoid and medullary have worse Px
What is the main mode of spread of RCC
hematogenous
what is another name for clear cell renal carcinoma
hypernephroma
What does a sarcamatoid RCC look like
spindle cells simulating mesenchymal neoplasm
what does collecting duct RCC look like
branching tubules lined by cuboidal cells
What does renal medullary RCC look like
in patient with sickle cell
poorly differentiated and heavily infiltrated with neutrophils
What type of cancer arises from urothelium of renal pelvis
urothelial(transitional cell) carcinoma of renal pelvis
50% of people with urothelial carcinomas have what other type tumor
bladder
what nephropathies are urothelial carcinomas assoc with
analgesic and tubulo-interstitial
what are signs of urothelial carcinoma
hematuria, small, may block outglow and cause hydronephrosis and flank pain
What is the 5 yr survival rate for urothelial carcinoma of renal pelvis
50-100% for low grade noninvasive lesions
10% for high grade infiltrating tumors
