Final Patho L5 Flashcards
المحاضره عن certain kidney tumors مهم نعرفها في الUS
🤩
Urithelial carcinoma
Is one of the commonest tumor that occurs in the bladder
Tumor
Arising from the cells that is lining the organ
Less IMP
The two most common Benin tumer are
Papillary adenoma. >Asymptomatic
Oncocytoma.> symptomatic and arising from distal tubule (collecting duct)
🪭Onco means pink so it has pink cytoplasm (eosinophilic cytoplasm)
is the most common type of kidney cancer, and it typically represents around 80-85% of all kidney malignancies. RCC originates from the cells lining the small tubes in the kidney that filter waste from the blood.
Renal Cell Carcinoma
malignant
Renal cell carcinoma> Arising from the tubule itself (more common in adults)
Wilm’s tumor >(common in children) arising from primitive tubules,, primitive means embryonal cell naive cell and immature
شكل الورم مميز فيهblastema فيه component نشوفها بس في الimmature baby
The most common tumor in The areas from renal pelvic to down is urothelial carcenoma
🫐مشكلته الrecarnce يروح ويرجع بعد شهر مثلا لذلك عادة لازم يكون in surveillance
🫐in situ (very common)
🫐most common cance in people
🫐الprognosisحقته مره كويسه
🫐they can do intervention and remove the tumor
🫐it is not infeltrating the bladder wall
There is also urithelial carcinoma infiltrating the bladder wall
في دي الحاله لازم يخرجو كل الbladder برا يعملو cystectomy وفي الغالب ياخذو الileum ويعملو modification يجربوه ل bladderبس لها مضاعفات لكن احيانا يضطرو يسووها
RCC
🩵arising from the tubular epithelial cell
🩵it is one type of adenocarcinoma>forming gland
🩵Represent 80-85% of kidney malignant tumors
إذا واضح انو very common ممكن في شهر يجي 6-5 حالات من هذا النوع من الورم
🩸 RCC. is the most common type of kidney cancer, and it typically represents around 80-85% of all kidney malignancies. RCC originates from the cells lining the small tubes in the kidney that filter waste from the blood.🩸
🩵70سنه-60سنه
M-F 2:1
Risk factor for RCC
🤍Smoking ,obesity, hypertension, exposure بكميات عاليه لto cadmiumماده لصناعة الفايبز
🤍 patient with polycystic kidney disease have higher risk 30*to develop RCC عن الناس العامه والعادية
🤍Genetic predisposition/ Familial type.
🌟🌟🌟Familial From of RCC(this is very imp syndrome
(VHL syndrom)von hippel_lindau syndrom
⚡️فيه VHLجين موجود على كروموسوم ٣ (لما يصير له mutation المريض رح يكون عنده الsyndrom
-it is an autosomal dominant means that if he inherit one abnormal gene from one of his patient they will develop the syndrome
-it has higher association RCC
➡️ VHL is subtype of RCC
🔽
Associated with clear cell type
سميت كذا لان الخلايا حقت السايتوبلازم نظيفه يعني بيضاء بسبب انو الfatتحلل من مادهزالفورمالين الضافه
-it is state syndrom charactrais by by: Hemangioblastomas (is a brain tumor)
غالبا يكون بايلاترال وملتبل ليجن-
يعني إذا عند المريض RCC by this syndromفي كليه وحده الكليه الثانيه معرضه للخطر انو بجيها RCC
Subtype of RCC is a lot but the most common type are
Clear cell RCC من الاسم يعني الخلايا فيها كليرنق
Papillary RCC >forming papilli
Chromophobe RCC
Morphology:
Grossly🥁and Spread🎸
🥁All RCCl large and spherical masses
🥁Cut surface yellow-gray-white or tan-brown.
🥁معضم الRCCتكون cystic وفيها hemorage
🥁usualy have well defined margin
🎸most characteristic feature of RCC is Invasion of the renal vein
الRCCيحب الvein ينمو فيه(في الصور لى نلاحظ عندنا massجنب الvein ثم الmassهذا يروح يمشي للvein وينمو جواته او ممكن يروح ينمو في ال adrenal glandاللي فوق الكلى
Morphology of clear cell carcinoma
🍫الcytoplasm أبيضّ فاضي لأنه الcytoplasm فيه lipidكثير والفورمالين يذوب الدهوناللي جوة الcytoplasm
🍦have some vacules
🍡the arrangement :because it is arising from renal tubule they trying to form the same so it makes tubular structure
Clinical course of RCC
معضم مرضى الRCC 50%يجو ب hematouria اما gross او microscopic 🥕
🧀Palpablemass,flankpain
🌟🌟🌟clinical presentation
Tried:
- painless hematuria,
- Long-standing fever,
- dull flank pain
Extra renal effect Of RCC
🍨Fever>الخلايا في الار سي سي تفرز سايتوكاينز هذي الساينوكاينز تؤثر على مركز معين في الجسم اسمه هيبوكامبس فيرفع والمريض يجي له فيڤر
🩸معضم الtumors تسبب fevor لهذا السبب⤴️
Polycythemia 5-10% (erythropoetin
release)
🍭الRCCهي cells secrete erithropoiten like substance ف المريض يجب له polycythemia
يعني الRbcsزادت عند المريض
🍧الRCC من الtuners اللي تحب تغزو
It like to invaid the vein
ف الrisk of hematognus spread is high so it has commonly metastasis للكلى و الboneواحيانا الskin كمان يكون عندو mad في الskinتشبه الRCC
What are the benign and malignant renal parenchyma neoplasms?
🍓Benign:Papillary adenoma, Oncocytoma
🍓Malignant:Renal Cell Carcinoma (adult), Wilm’s Tumor (children)
What are the benign and malignant renal parenchyma neoplasms?
🍓Benign:Papillary adenoma, Oncocytoma
🍓Malignant:Renal Cell Carcinoma (adult), Wilm’s Tumor (children)
What is the most common type of renal cell carcinoma?
Clear cell renal cell carcinoma.
List some risk factors for renal cell carcinoma.
- Smoking
- Hypertension
- Obesity
- Occupational exposure to cadmium
- Acquired polycystic disease
- Genetic predisposition (e.g., Von Hippel-Lindau syndrome)
Describe the gross morphology of renal cell carcinoma.
- Large, spherical masses
- Cut surface is yellow-gray-white or tan-brown
- May contain cystic areas and hemorrhage
- Well-defined margins
What is Wilms’ tumor, and who does it primarily affect?
Wilms’ tumor (nephroblastoma) is the most common primary tumor of the kidney in children, typically affecting those under 10 years old.
What are the classic symptoms of renal cell carcinoma?
- Painless hematuria
- Long-standing fever
- Dull flank pain
What is the most common presenting manifestation of urothelial carcinoma?
Painless hematuria.
What are the potential causes associated with urothelial carcinoma?
- Cigarettes
- Aniline dye (Beta-naphthylamine)
- Schistosomiasis
- Cyclophosphamide
What is the prognosis of Wilms’ tumor with therapy?
Very good, with 2-year survival rates as high as 90%, which usually implies a cure.
What is the prognosis of Wilms’ tumor with therapy?
Very good, with 2-year survival rates as high as 90%, which usually implies a cure.
Name a benign renal parenchyma neoplasm.
Papillary adenoma.
What is the most common malignant tumor of the kidney?
Renal Cell Carcinoma.
What is the most common malignant tumor of the kidney?
Renal Cell Carcinoma.
Which tumor is primarily found in children?
Wilm’s Tumor.
What type of carcinoma constitutes 80-85% of kidney malignant tumors?
Renal Cell Carcinoma.
What demographic is most affected by renal cell carcinoma?
Individuals in their 6th to 7th decade of life.
What is the male to female ratio for renal cell carcinoma?
2:1
List two risk factors for renal cell carcinoma.
Smoking and hypertension.
What genetic syndrome is associated with clear cell renal cell carcinoma?
Von Hippel-Lindau syndrome.
🌟🌟 What is the classic triad of symptoms for renal cell carcinoma?
Painless hematuria, long-standing fever, dull flank pain.
What is the most common primary kidney tumor in children?
Wilm’s Tumor.
What chromosome is associated with the loss of the WT-1 gene in Wilm’s Tumor?
Chromosome 11.
What are the three components of the classic triphasic combination in Wilm’s Tumor?
Blastemal, immature stroma, immature epithelial element.
What is the most common presenting symptom of urothelial carcinoma?
Painless hematuria.
What type of epithelium lines the urinary bladder?
Transitional (urothelial) epithelium.
Name a potential cause of bladder cancer.
Cigarette smoking.
What is the age range most affected by urothelial carcinoma?
50-70 years.
What is the prognosis of Wilm’s Tumor with therapy?
Very good; survival rates can be as high as 90%.
What is the predominant type of renal cell carcinoma?
Clear cell renal cell carcinoma.
What is the predominant type of renal cell carcinoma?
Clear cell renal cell carcinoma.
What are the typical characteristics of renal cell carcinoma morphology?
Large, spherical masses with yellow-gray-white cut surfaces.
What are the two types of urothelial carcinoma?
Papillary and flat.
What is the clinical outcome of urothelial carcinoma dependent on?
Both grade and stage of the cancer.
What is a common complication of renal cell carcinoma?
Metastasis to lungs and bones.
What type of renal cell carcinoma is associated with hemangioblastomas?
Clear cell type (Von Hippel-Lindau syndrome).
What is a common clinical manifestation of Wilm’s Tumor?
Abdominal mass.
What is the relationship between urothelial carcinoma and ureter obstruction?
It often causes obstruction rather than metastases.
How does renal cell carcinoma commonly spread?
Invasion of perinephric fat and renal vein.
What is the appearance of clear cell renal cell carcinoma cells?
Solid or vacuolated, “lipid-laden” clear cells.
What is the significance of the “VHL gene” mutation?
It is associated with Von Hippel-Lindau syndrome and clear cell renal cell carcinoma.
What type of renal tumor originates from tubular epithelial cells?
Adenocarcinoma
What is the clinical manifestation of renal cell carcinoma related to erythropoietin?
Polycythemia (5-10% of cases)
What is a common genetic predisposition to renal cell carcinoma?
Familial type, including Von Hippel-Lindau syndrome.
What are the potential effects of renal cell carcinoma?
Fever, hypercalcemia, hypertension, and hormonal effects.
What is the most common age group for Wilms’ Tumor?
Children under 10 years
Describe the cut surface appearance of Wilms’ Tumor.
Homogeneous, pale tan-gray with foci of hemorrhage and necrosis.
What is the key pathological feature of urothelial carcinoma?
It can be invasive or non-invasive, low grade or high grade.
What is the prognosis for urothelial carcinoma arising in the collecting system?
Poor prognosis due to thin walls
What is a common risk factor specific to bladder cancer?
Exposure to aniline dyes.
What is the typical gender ratio for bladder cancer?
3:1 (male to female).
What is the typical gender ratio for bladder cancer?
3:1 (male to female).
What are the two grades of urothelial carcinoma?
Low grade and high grade.
What is a clinical symptom of Wilms’ Tumor besides an abdominal mass?
Hematuria
What type of renal tumor is characterized by clear cells?
Clear cell renal cell carcinoma.
What type of renal tumor is characterized by clear cells?
Clear cell renal cell carcinoma.
What does the term “abortive tubules” refer to in Wilm’s Tumor?
Immature epithelial elements in the tumor.
What is the risk of acquired polycystic kidney disease in chronic dialysis patients?
30 times increased risk for renal cell carcinoma.
What is the significance of giant cells in renal cell carcinoma morphology?
Indication of anaplasia and aggressive behavior.
What are the classic features of renal cell carcinoma on imaging?
Well-defined margins, cystic areas, and hemorrhage.
What is the typical presentation of Wilms’ Tumor?
Abdominal mass and possible abdominal pain.
How is the prognosis for adults with renal cell carcinoma described?
Variable, depending on stage and metastasis.
What is a common treatment approach for Wilms’ Tumor?
Combination of chemotherapy and surgery.
