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Applied Anatomic Pathology > GU/Kidney > Flashcards

GU/Kidney Flashcards

1
Q

what is the most common cause for a cystectomy

A

muscle invasive urothelial carcinoma

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2
Q

a male radical cystectomy can be oriented anterior/posterior using what primary structure

A

peritoneal reflection - it is much shinier on the posterior aspect

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3
Q

relevant clinical history (pre-work) to identify before grossing a cystectomy include what three things

A

indication for surgery
location of tumor
preoperative treatments

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4
Q

what three measurements should be taken of a prostate attached to a cystectomy specimen

A

left to right
anterior to posterior
apex to bladder neck

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5
Q

what are the three measurements that should be taken of the bladder in a cystectomy case

A

bladder neck to dome
left to right
anterior to posterior

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6
Q

what are the three extra measurements that should be taken in a male cystectomy specimen

A

L/R vas deferens
L/R seminal vesicles (3 dimensions)
L/R ureters

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7
Q

what are the two most important margins to take on a male cystectomy

A

L/R ureteral margins
distal urethral margin

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8
Q

the bladder should be opened _____ from distal urethral margin through dome

A

anterior

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9
Q

if no lesions are identified, where should you take sections in a cystectomy specimen

A

dome
trigone
anterior wall
posterior wall
L/R lateral walls
ureteral orifices

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10
Q

if a lesion is identified, where should you take sections in a cystectomy specimen

A

representative sections of mass (1/cm)
tumor to normal
tumor to prostate or ureteral orifices
tumor with deepest invasion
tumor to margin

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11
Q

after sectioning the bladder, you identify an area of wall thinning, what might this represent

A

scaring from a prior transurethral resection site

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12
Q

what is the CPT code adrenal glands

A

88307

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13
Q

what is Conn syndrome

A

excessive cortisol production by the adrenal cortex

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14
Q

sprionolactone bodies are seen in which condition

A

adrenal cortical adenoma

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15
Q

which kidney lesion is variegated and poorly demarcated with necrosis, hemorrhage, and cystic change

A

adrenal cortical carcinoma

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16
Q

what is waterhouse-friderichson syndrome

A

bacterial infection of the adrenals causes major adrenal insufficiency which leads to hypertension

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17
Q

what is a myelolipoma (incidentaloma)

A

adrenal tumor with mature adipose tissue and normal bone marrow elements

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18
Q

what is another name for a myelolipoma

A

incidentaloma

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19
Q

what is the difference in gross appearance of a small and large adrenal pheochromocytoma

A

small: yellow-tan
large: hemorrhage, necrosis, and cystic

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20
Q

how should you process an adrenal specimen

A

weight with fat before fixing
measure
ink surface
serially section along short axis

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21
Q

what is the normal weight of an adult adrenal gland

A

7-10 grams

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22
Q

what is the critical size for an adrenal tumor

A

<5 cm - pT1
>5 cm - pT2

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23
Q

you would see a blunted calyx in which condition of the kidney

A

chronic pyelonephritis

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24
Q

most renal calculi are made of what

A

calcium oxalate

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25
Q

what are the two benign, neoplastic conditions of the kidney

A

angiomyolipoma
oncocytoma

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26
Q

what are the 5 variants of renal cell carcinoma

A

clear cell
papillary
chromophobe
Xp11 translocation
collecting duct

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27
Q

what is the most common variant of renal cell carcinoma

A

clear cell

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28
Q

what is the most common primary renal tumor of childhood

A

Wilms tumor

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29
Q

how should you process a kidney

A

weigh with fat
note presence or absence of adrenal gland and measure if attached
quantify fat and presence of Gerota’s fascia
measure ureter
evaluate renal vein for tumor or thrombus
take shave margins
bivalve

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30
Q

define ipsilateral

A

same side

31
Q

define contralateral

A

opposite side

32
Q

a kidney tumor >7 cm is staged as what

A

pT2 and up

33
Q

a kidney tumor that invades the renal vein is staged as what

A

pT3a - regardless of tumor size

34
Q

a kidney tumor that invades into Gerota’s fascia is staged as what

A

pT4

35
Q

what’s important to note about kidney staging

A

if there is metastasis, it is staged differently so it is important to note whether you have one great lesion or two separate ones

36
Q

what is important to note about the fat surrounding the ureter

A

you should never strip it if you received it with a ureter specimen as it is important for staging (invasion)

37
Q

what is the CPT code for a ureter

A

88307

38
Q

what is the most common cause of hydronephrosis in infants and children

A

ureteropelvic junction (UPJ)

39
Q

tumor invasion into the periureteric fat stages a ureter to what

A

pT3

40
Q

what is the most important risk factor for bladder cancer

A

smoking

41
Q

what are the four main morphologic patterns of bladder tumors

A

papilloma
invasive papillary carcinoma
flat non-invasive carcinoma (CIS)
flat invasive carcinoma

42
Q

what is the CPT code for a bladder specimen

A

88309

43
Q

how should you open a bladder

A

anteriorly along the dome

44
Q

what is the key concept for bladder staging

A

invasion - important to give full thickness section

45
Q

how can you orient the prostate

A

posterior aspect is flatter, anterior aspect is more rounded

46
Q

what is the verumontanum

A

the rounded portion around the urethra in the prostate

47
Q

what is the adenexa

A

term used for the seminal vesicles and vas deferens

48
Q

what is the normal weight of a prostate

A

15-40 grams

49
Q

what is the normal weight of a prostate with benign prostatic hyperplasia (BPH)

A

60-100 grams

50
Q

what is a simple prostatectomy

A

large chunks of the prostate are removed in the case of benign prostatic hyperplasia
weigh, measure in aggregate, and do not ink because there is no capsule

51
Q

how does PSA relate to prostate cancer

A

PSA is a protein produced by normal and malignant cells of the prostate
elevated levels can indicate cancer

52
Q

what is is important to know about the Gleason scoring system

A

prostate staging
the higher the number, the higher the grade and worse the cancer is

53
Q

what is considered the base of the prostate

A

area in contact with the bladder

54
Q

what does a smooth and glistening aspect of the prostate represent

A

capsule - important to note as it’s a pertinent negative

55
Q

what are corpora amylacea

A

amyloid bodies found in the damaged prostate - note and removed before submitting section

56
Q

what is the most important concept of prostate staging

A

extension beyond capsule

57
Q

what is the outermost layer of the testicle

A

tunica vaginalis

58
Q

what is the most common type of tumor in 15-45 year old males

A

germ cell tumors of the testicle

59
Q

what is the most common type of germ cell tumor

A

seminoma

60
Q

what is the most common testicular tumor in infants/children up to 3 years of age

A

yolk sac tumor

61
Q

what is the gross appearance of a seminoma

A

homogeneous, gray white lobulate surface

62
Q

what is the gross appearance of an embryonal carcinoma

A

variegated with areas of hemorrhage and necrosis

63
Q

what is the gross appearance of a yolk sac tumor

A

yellow tan with focal myxoid/gelatinous areas with focal hemorrhage

64
Q

what is the gross appearance of choriocarcinoma

A

soft and friable mass with hemorrhage and necrosis

65
Q

what is the gross appearance of a leydig cell tumor

A

yellow-green lobules separated by fibrous bands

66
Q

what is the gross appearance of a Sertoli cell tumor

A

small well circumscribed white homogenous nodule

67
Q

what is important to note about the inside of a testicle while grossing

A

does it string with ease

68
Q

what is the most important factor of testicle staging

A

size (3 cm), location, and distance to margins

69
Q

what are the most common types of penile neoplasms

A

HPV and non-HPV related squamous cell carcinoma

70
Q

how should you open a penile specimen

A

along the urethra from proximal to distal glans

71
Q

what is the most important factor of penile staging

A

invasion into parenchyma

72
Q

what is the CPT code for a testicle with tumor

A

88309

73
Q

what is the CPT code for a penile specimen

A

88309

Applied Anatomic Pathology (17 decks)

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