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Year2 Renal > Exam 2- Tumors > Flashcards

Exam 2- Tumors Flashcards

1
Q

What is the most common benignrenal cancer

A

renal papillary adnoma

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2
Q

What are the benign cancers of the kidneys

A

renal papillary adenoma, angiomyolipoma, oncocytoma, renal fibroma or hamartoma
juxtaglomerular cell tumor
mesenchymal tumores

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3
Q

What is the size of a benign ademoa

A

<1 cm

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4
Q

what are ademoas that are >1cm in diameter

A

low grade RCC

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5
Q

What is the gross appearance or papillary ademoas

A

cortical, discrete, yellow gray, small and there may be multiple of them
may have psammoma bodies
acidophilic cytoplasm

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6
Q

what genetic mutation is assoc with renal papillary ademoa

A

trisomy 7 and 17

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7
Q

What disease has 25-50% patients present with angiomyolipomas

A

tuberous sclerosis

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8
Q

What is tuberous sclerosis and what is mutation involved

A

TSC1 or 2 (tumor suppressor genes
autosomal dominant
tumores or lesions of brain(mental retardation), skin, kidney, hear, lungs and eyes
lisch nodules

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9
Q

Angiomyolipomas greatest risk factor is what

A

susceptible to spontaneous hemorrhage, massive retroperitoneal hemorrhage and shock

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10
Q

Where do oncocytomas arise from

A

type A intercalated cells of renal cortical collecting ducts

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11
Q

what is the morphology on oncocytomas

A 
epithelial tumor with large eosinophilic cells, large round nuclei
numerous mitochondria
large tan or brown mahogany color. 
get grow to 12 cm
stellate scar
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12
Q

What is the familial association with oncocytomas

A

familial 10 q deletion with multicentricity and b/l

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13
Q

What are oncocytomas confused with

A

RCC , non clear cell

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14
Q

What age gorup are oncocytomas Dx in

A

adults.

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15
Q

What is the population of tuberous sclerosis and renal angiomyolipoma

A

middle aged females

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16
Q

What is the most common adult renal malignant tumor

A

RCC

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17
Q

what population is RCC seen mostly in

A

60-80 yrs old male to femal 2:1 equal distribution racially

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18
Q

what does RCC arise from

A

renal tubular epithelium, adenocarcinoma

19
Q

what are the risk factors assoc with RCC

A

SMOKING

HTN obesity, estrogens, asbestos, chronic renal disease, tuberous sclerosis, acquired cystic disease

20
Q

What is the hereditary form of RCC

A

autosomal dominant
younger patients
VHL syndrome develop b/; hereditary clear cell carcinoma or hereditary papillary carcinoma

21
Q

What is the most common type of RCC

A

clear cell
clear granular cytoplasm
non papillary
95% sporadic

22
Q

what is the mutation seen with clear cell carcinoma familial

A

loss of sequences on short arm of chromosome 3. deletions or translocations
this is the VHL tumor supressor gene

23
Q

What is Birt Hogg Dube syndrome and what type inheritance

A

folliculin gene mutation, autosomal dominant

skin pulmonary and renal tumors

24
Q

What type of mutation is seen in papillary carcinoma

A

trisomy 7, 16,17 lost Y (MET oncogene)

25
Q

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?

A

Xp11 translocation carcinoma

collecting (bellini) duct carcinoma

26
Q

What is the morphology of chromophobe renal carcinoma

A

pale eosinophilic cytoplasm, nuclear halos,
arise from type B intercalated cells of renal Cx collecting ducts
solid growth pattern

27
Q

What does chromophobe renal carcinoma resemble

A

oncocytoma

28
Q

where are papillary tumors clinically found

A

distal convoluted tubles
b/l
can invade renal vein, vena cava

29
Q

What is the classic triat of RCC

A

hematuria (microscopic usually)
CVA pain
palpable flank mass

30
Q

When RCC are Dx whats the main concern

A

already have metastasized

31
Q

What are the begining symptoms of RCC

A

weight loss, malaise, weakness, fever

32
Q

where does RCC metastasize to

A

lung, bone, regional nodes, liver, adrenal brain and unusual sites

33
Q

Rank the types of RCC histologic types and associated prognostic value

A

papllary and chromophobe have better Px
clear cell is moderate
collecting duct, sarcamatoid and medullary have worse Px

34
Q

What is the main mode of spread of RCC

A

hematogenous

35
Q

what is another name for clear cell renal carcinoma

A

hypernephroma

36
Q

What does a sarcamatoid RCC look like

A

spindle cells simulating mesenchymal neoplasm

37
Q

what does collecting duct RCC look like

A

branching tubules lined by cuboidal cells

38
Q

What does renal medullary RCC look like

A

in patient with sickle cell

poorly differentiated and heavily infiltrated with neutrophils

39
Q

What type of cancer arises from urothelium of renal pelvis

A

urothelial(transitional cell) carcinoma of renal pelvis

40
Q

50% of people with urothelial carcinomas have what other type tumor

A

bladder

41
Q

what nephropathies are urothelial carcinomas assoc with

A

analgesic and tubulo-interstitial

42
Q

what are signs of urothelial carcinoma

A

hematuria, small, may block outglow and cause hydronephrosis and flank pain

43
Q

What is the 5 yr survival rate for urothelial carcinoma of renal pelvis

A

50-100% for low grade noninvasive lesions

10% for high grade infiltrating tumors

Year2 Renal (20 decks)

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