G Urinary Flashcards
RCC is what kind of cancers?
adenocarcinomas (mostly)
arise from the proximal tubule
types of tumour found in kidenys
RCC
Transitional cell carcinoma
Lymphoma
Epithelial _ carcinoid / teratoma
RCC T staging,
what are the main jump points?
T1a less than 4cm
T3a - extends in to renal vein
T4 - beyond grottas fascia
when are RCC best seen - time of scans
is there benefit to earlier cortico medullary phas?
100s
yes for vascular anatomy, and pseudo tumours
what will an RCC look like?
lobulated contour of the kidney
central calcification (often present / bad)
RCC enhancement and deliniate from a benign lesions
what are the HU metrics
if pre and post difference 20HU - likely tumour
10-20 - indeterminate
les than 10HU is benign
vasculairty of cystic septa
badness.
Cystic morphology RCC is possible
signs that help differentiate a true tumour invasion of the veins from bland thrombus are:
tumour expands the vessel
expansion could be just increased flow though, be careful
If a threshold of 1 cm short axis is used there will be what false negative rate
4%
ARE RCC VASCULAR
YES - brighlty seen on arterial phase
conditions that increase risk of RCC
Tuberous sclerosis
VHL
End stage renal failure
What is Von Hippel Lindau Syndrome?
Auto Dom disease.
VHL gene is a tumour supressor gene.
lots of cysts present that lined by clear cells, can become malignant
if over 3cm remove
What are the other tumours of the kideny?
Urothelial: TCC / SCC
Wilms nephroblastoma
Collecting duct carcinoma
medullary carcinoma (sickle cell trai ax)
Sarcomas
Epithelial: Teratoma / Carcinoid
Lymphoma
Mets
histology of Wilms tumour
Macroscopic jelly-like areas and haemorrhage producing a cystic appearance and microscopically epithelial and non-epithelial elements which may produce muscular, fatty or bone components.
do kidneys contain lymphoid tissue?V
no
mets to kidney is from which organs?
opposite kidney
breast and lung
Typically has necrotic lymph node metastases and arises from squamous metaplasia of chronically-inflamed urothelium, usually due to stone disease.
SCC
prostate cancers are mostly what type of cancer?
adenocarcinoma arising from glandular epithelial lining
Gleason charachterises what?
aggressiveness
Based on very well differentiated to undifferentiated
scored out of 10. 8-10 aggressive
Each tumour focus is individually graded on a five-point scale (the Gleason grades) and the two most common grades are added together to give a Gleason score or sum
Prostate cancer T staging
T1 abc, present, incidental <5% or more than, tumour on biospy.
T2 abc- gland confined, one lobe two lobes
T3 out of capsule
link between PSA level and positive bone scan
If the PSA levels are between 10.1-19.9 ng/ml, the likelihood is 5%
If the PSA levels >20 ng/ml, the likelihood is 16%
prostate capsule will have tumour extension through which parts? due to weakness
Neurovascular bundles
Seminal vesicles
Ejaculatory ducts
Apex of the gland
Prostate capsule
Magnetic resonance spectroscopy
Three metabolites are measured:
Citrate
Creatine
Choline
Magnetic resonance spectroscopy
how does it work
Prostate cancer has significantly higher choline and lower citrate levels compared to normal tissue and benign prostatic hyperplasia.
signs of extra-capsular tumour are:
Irregular capsular bulge or retraction
Periprostatic fat irregularity
Obliteration of rectoprostatic angle
Enlarged neurovascular bundle
Long length of contact
adrenal medulla contains what kind of cells
neuroendocrine cells
