Histopathology 14: Urological Pathology Flashcards
Name 3 benign renal neoplasms
Papillary adenoma
Renal onocytoma
Angiomyolipoma
List 3 types of renal calculi
Calcium oxalate
Magnesium Ammonium phosphate
Uric acid
Infection with which organisms leads to magnesium ammonium phosphate calculi ?
Urease producing organisms - Proteus
What is a stag horn calculus ?
A very large magnesium ammonium phosphate stone
In which syndrome do you get renal Onocytoma ?
Birt-Hogg-Dubé syndrome
Which benign renal neoplasm is seen in tuberous sclerosis ?
Angiomyolipoma
List risk 5 risk factors for renal cell carcinoma ?
Smoking Obesity Long term dialysis Von hippel Lindau syndrome Aromatic amines
List 3 subtypes of renal cell carcinoma ?
clear cell renal cell carcinoma (70%)
Papillary renal cell carcinoma (15%)
Chromophobe renal cell carcinoma (5%)
10% other
Name 1 malignant renal tumour of childhood?
Nephroblastoma (Wilm’s tumour)
Which 3 genetic mutations are commonly associated with Papillary adenoma / carcinoma
Trisomy 7
Trisomy 17
Deletion of Y chromosome
List 3 treatments for benign prostatic hyperplasia (BPH)?
5 alpha reductase inhibitors
Alpha blockers
transurethral resection of the prostate (TURP)
What scoring system is used to predict prognosis of prostatic adenocarcinoma ?
Gleason score
25 year old male presents with a painless testicular lump. He has a history of an undescended testicle and was low birthweight.
What is the most likely neoplastic cause ?
A testicular germ cell tumour
List 5 subtypes of germ cell tumours?
Seminoma Choriocarcinoma Yolk sac tumour Post pubertal teratoma Embryonal carcinoma
Which subtype of testicular germ cell tumours shows a lace-like pattern on histology
Yolk sac tumour
Name a rare testicular non-germ cell tumour that may present with precocious puberty in pre-pubertal boys ?
Leydig cell tumour
List 3 testicular non-germ cell tumours ?
Lymphoma
Leydig cell tumour
Sertoli tumour
Which type of urinary calculi are most common ?
Calcium oxalate
List 2 causes of urate stones ?
- Gout
- Chemotherapy
What is the most common type of prostate cancer ?
adenocarcinoma
Which 3 markers are raised in teratoma ?
AFP
HCG
LDH
causes of the 3 types of stone
calcium oxalate (95%) - hypercalciuria
- absorptive hypercalciuria - too much absorbed in gut
- renal - impaired absorption in proximal renal tubule
magnesium ammonium phosphate (15%) - infection with urease-producing organisms (proteus)
- can be large (staghorn calculus)
uric acid (5%)- hyperuricemia - gout/rapid cell turnover (eg chemo)
where do stones tend to lodge
pelvi-ureteric junction
pelvic brim
vesico-ureteric junction
large stones stay in the kidney and lead to:
- obstruction
- risk of infection
- CKD
list benign renal neoplasms
papillary adenoma
renal oncocytoma
angiomyolipoma
features of papillary adenoma
benign epithelial kidney tumour made of papillae/tubules = 15mm well-circumscribed trisomy 7, 17, loss of chromosome Y
features of renal oncocytoma
benign epithelial kidney tumour made of oncocytic cells
well circumscribed
sporadic
seen in birt-hogg-dube syndrome
usually incidental finding
oncocytes = large cells with pink granular cytoplasm and prominent nucleolus
features of angiomyolipoma
benign mesencyhmal kidney tumour made of thick-walled bv, smooth muscle and fat
see in tuberous sclerosis
large tumours (>4cm) present with flank pain, haemorrhage and shock
features of renal cell carcinomas
malignant epithelial kidney tumours
mainly presents with PAINLESS HAEMATURIA
subtypes = clear cell renal cell carcinoma, papillary renal cell carcinoma, chromophobe renal cell carcinoma
papillary renal cell carcinoma
> 15mm
trisomy 7, 17, loss of Y chromosome
type 1 - single layer of small flat cells
type 2 - stratification of the cells
chromophobe renal cell carcinoma
sheets of large cells with distinct borders, reticular cytoplasm and a thick-walled vascular network
variable genetic abberations
well-circumscribed and solid brown
nephroblastoma (wilm’s tumour)
malignant triphasic kidney tumour of childhood
presents as an abdominal mass aged 2-5 yrs
excellent prognosis
features of urothelial carcinoma
aka transitional cell carcinoma
RF = smoking + aromatic amines
subtypes = non-invasive papillary urothelial carcinoma, infiltrating urothelial carcinoma, flat urothelial carcinoma in situ
features of BPH
benign enlargement of the prostate as a consequence of increased cell numbers
? increased oestrogen in the blood due to ageing - indices androgen receptors
presents with LUTS - FUND HIPS
features of prostatic adenocarcinoma
malignant epithelial prostate tumour
most common malignant tumour in men
arises from prostatic intraepithelilal neoplasia
mutations include - PTEN, AMACR, GST-pi, p27
gleason score
features of testicular germ cell tumours
90% of testicular tumours RF = undescended testes, low BW present as painless testicular lumps back pain, cough, dyspnoea types = seminoma, embryonal carcinoma post-pubertal teratoma, yolk sac tumour, choriocarcinoma (cytotrophoblasts and syncytiotrophoblasts)
treatment for testicular germ cell tumours
platinum based chemotherapy
name 3 testicular non germ-cell tumours
lymphoma
leydig cell tumour
sertoli cell tumour
list 5 paratesticuar diseases
epididymal cyst epididimitis - men <35 = c.trachomatis, N gonorrhoea varicocele hydrocele adenomatoid tumour
