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Histopathology > Histopathology 9 - Urological pathology > Flashcards

Histopathology 9 - Urological pathology Flashcards

1
Q

What is the most common composition of urinary calculi?

A

Calcium oxalate

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2
Q

What is the most likely cause of calcium oxalate urinary calculi?

A

Hypercalciuria
Either due to excessive Ca absorption from gut or impaired absorption in nephron (intrinsic renal problems)

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3
Q

What are magnesium ammonium phosphate urinary calculi also known as?

A

Triple stones

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4
Q

What is the cause of triple stones?

A

A consequence of infection with urease-producing organisms
Urease –> ammonia increase
Ammonia makes urine alkaline –> triple stone precipitation

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5
Q

Why might a small urinary stone become symptomatic?

A

If it gets out of kidney and gets into the ureter - it will cause colic at any point where the ureter bends

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6
Q

What type of urinary calculi are caused by gout?

A

Uric acid stones

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7
Q

What is papillary adenoma of the kidney?

A

Benign epithelial kidney tumour composed of papillae and/or tubules
ALWAYS 15MM OR LESS IN SIZE

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8
Q

What is a renal oncocytoma?

A

Benign epithelial kidney tumour composed of oncocytic cells

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9
Q

What syndrome should be considered in a patient with many renal oncocytomas?

A

Birt-Hogg-Dubé syndrome

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10
Q

What is an angiomyolipoma?

A

Benign mesenchymal kidney tumour composed of thick-walled blood vessels, smooth muscle and fat

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11
Q

In what condition are angiomyolipomas most likely to appear?

A

Tuberous sclerosis

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12
Q

What is a renal cell carcinoma?

A

Malignancy of epithelial cells of proximal convuluted tubule

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13
Q

What is the main symptom of renal cell carcinoma?

A

Painless haematuria

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14
Q

What is the most common subtype of renal cell carcinoma?

A

Clear cell renal cell carcinoma

(other types = papillary cell + chromophone)

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15
Q

What is the genetic association of clear cell carcinoma?

A

Loss of chromosome 3p

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16
Q

What is Nephroblastoma also known as?

A

Wilm’s tumour

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17
Q

What is nephroblastoma?

A

Triphasic kidney tumour of childhood

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18
Q

How does nephroblastoma typically present?

A

Abdominal mass in children aged 2-5

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19
Q

What is the new name for transitional cell carcinoma?

A

Urothelial carcinoma

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20
Q

What are the 2 main treatments of BPH?

A

5 alpha reductase inhibitors
Alpha blockers

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21
Q

What score is used for prostatic adenocarcinoma?

A

Gleason score

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22
Q

What is the most common type of testicular tumour?

A

90% = germ cell

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23
Q

Recall 2 risk factors for testicular germ cell tumours

A

Undescended testes
Low birth weight

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24
Q

What are the histological subtypes of germ cell testicular tumour?

A

Seminoma
Embryonal carcinoma
Post-pubertal teratoma
Yolk Sac Tumour

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25
Q

What is the most useful form of chemo in germ cell testicular tumours?

A

Platinum based

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26
Q

What are the 3 subtypes of non-germ cell testicular tumours?

A

Lymphoma
Leydig cell
Sertoli cell

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27
Q

Which type of testicular tumour can present with precocious puberty?

A

Leydig cell

28
Q

What is flat urothelial carcinoma in situ?

A

Very high grade lesion with high risk of progression

29
Q

Which testicular germ cell tumour has clear polygonal cells and a lymohcytic inflitrate?

A

Seminoma

**equivalent of dysgerminoma in females**

30
Q

Which type of urinary stone is most likely to develop into a massive “staghorn calculus”?

A

Triple stone

31
Q

What is the typical histological appearance of non-invasive papillary urothelial carcinoma?

A

Frond-like growths

32
Q

What is the typical histological appearance of a seminoma?

A

Clear polygonal cells and lymphocytic infiltrate

33
Q

Where in the kidneys do renal stones form?

A

Collecting ducts

34
Q
A
35
Q

What type of stone does magneisum ammonium phosphate stone form?

A

Staghorn calculus - large and painful

36
Q

Common points of impaction of renal stones

A

PUJ

37
Q
A
38
Q

Histology of BPH

A
39
Q

Treatment of BPH

A
40
Q

Most common cause of prostate cancer in men over 50y

A

Adenocarcinoma

41
Q

Precursor lesion of prostate cancer

A

Prostatic intraepithelial neoplasia

42
Q
A
43
Q

Which zone of the gland does prostate cancer arise in?

A

Peripheral zone

44
Q

PSA that diagnoses prostate cancer

A

>4ng/ml

45
Q

Most common tumour of the testes

A

Germ cell tumours

46
Q

Examples of germ cell tumours of testes

A

Seminoma

Spermatocytic seminoma

Embryonal carcinoma

Yolk sac tumour

Choriocarcinoma

Teratoma

47
Q

Predisposing factors of germ cell tummours

A

Cryptorchidism, testicular dysgenesis,
genetic factors e.g. Kleinfelters, testicular feminisation

48
Q

Example of non germ cell tumour

A

Leydig cell tumour

Sertoli cell tumour

49
Q

Examples of benign renal tumours

A

Papillary adneoma

Oncocytoma

Angiomyolipoma

50
Q

What is papillary adenoma

A

Renal epithelial tumour with papillary architecture

<5mm

51
Q
A

Renal papillary adenoma

52
Q

Compare the benign renal tumours

A
53
Q

3 types of malignant renal tumours

A

Renal cell carcinoma

Nephroblastoma

Transitional cell carcinoma

54
Q

Most common malignant epithelial tumour

A
55
Q

RF for renal cell carcinoma

A

Smoking, HTN, obesity, long-term dialysis

56
Q

what’s the 2nd most common childhood malignancy?

A

Nephroblastoma

57
Q

Most common location of transitional cell carcinoma

A

Bladder

58
Q

3 types of renal cell carcinoma

A

Clear cell (70%)

Papillary (15%)

Chromophobe (5%)

59
Q

Histology of clear cell renal cell carcinoma

A

Macro- Golden yellow iwth haemorrhagic areas

Micro- nests of epithelium with clear cytoplasm

60
Q

Papillary: histology

A

Macroscopic: friable brown tumour

Micro- paipllary/tubulopaipllary growth pattern >5mm

61
Q

Chromophobe tumour: histological appearance

A

Macro- solid brown tumour

Micro- sheets of large cells, distinct cell borders

62
Q

Nephroblastoma histology

A

Micro- small round blue cells, epithelial component - cells trying to differentiate and form primitive renal tubules

63
Q

Two types of transitional cell carcinoma

A

a) non-invasive papillary

Frond like growths
projecting from bladder
wall, often multifocal
Microscopic – papilliary
fronds lined by urothelium
Can either be low grade
or high grade

b) invasive urothelial carcinoma

Tumour with invasive
behaviour. Usually grow
as solid masses, fixed to
tissue

64
Q

Most common bladder tumour

A

Urothelial (transitional cell)

65
Q

RF for squamous cell carcinoma of bladder

A

Schistosomiasis

66
Q
A

Histopathology (18 decks)

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