Histopathology 9 - Urological pathology Flashcards
What is the most common composition of urinary calculi?
Calcium oxalate
AKA Weddelite
What is the most likely cause of calcium oxalate urinary calculi?
Hypercalciuria
Either due to excessive Ca absorption from gut or impaired absorption in nephron
What are magnesium ammonium phosphate urinary calculi also known as?
Triple stones
What is the cause of triple stones AKA Magnesium ammonium phosphate ?
A consequence of infection with urease-producing organisms
Urease –> ammonia increase
Ammonia makes urine alkaline –> triple stone precipitation
Why might a small urinary stone become symptomatic?
If it gets out of kidney and gets into the ureter - it will cause colic at any point where the ureter bends
What type of urinary calculi are caused by gout?
Uric acid stones
What is papillary adenoma of the kidney?
What size are they?
Benign epithelial kidney tumour composed of papillae and/or tubules
ALWAYS 15MM OR LESS IN SIZE
What is a renal oncocytoma?
What does histology show?
Benign epithelial kidney tumour composed of oncocytic cells
Histology: Oncocytes are the large cells with pink granular cytoplasm and a prominent nucleolus
What syndrome should be considered in a patient with many renal oncocytomas?
Birt-Hogg-Dubé syndrome
What is an angiomyolipoma?
Benign mesenchymal kidney tumour composed of thick-walled blood vessels, smooth muscle and fat
NB Angio= blood, myo= muscle, lipo= fat
In what condition are angiomyolipomas most likely to appear?
Tuberous sclerosis
What is a renal cell carcinoma?
Malignancy of epithelial cells of proximal convuluted tubule
What is the main symptom of renal cell carcinoma?
Painless haematuria
NB Most of the remaining cases are detected incidentally on imaging
What is the most common subtype of renal cell carcinoma?
Clear cell renal cell carcinoma (70%)
other types = papillary cell (15%) + chromophone (5%)
What is the genetic association of Clear Cell Renal Cell Carcinoma?
Loss of chromosome 3p
What is Nephroblastoma also known as?
Wilm’s tumour
How does nephroblastoma typically present?
Abdominal mass in children aged 2-5
What is the new name for transitional cell carcinoma?
Urothelial carcinoma
What are the 2 main treatments of BPH?
5 alpha reductase inhibitors
Alpha blockers
What score is used for prostatic adenocarcinoma?
Gleason score
What is the most common type of testicular tumour?
90% = germ cell
Recall 2 risk factors for testicular germ cell tumours
Undescended testes
Low birth weight
What are the histological subtypes of germ cell testicular tumour?
Seminoma
Embryonal carcinoma
Post-pubertal teratoma: THIS IS MALIGNANT
Yolk Sac Tumour
What is the most useful form of chemo in germ cell testicular tumours?
Platinum based
What are the 3 subtypes of non-germ cell testicular tumours?
Lymphoma
Leydig cell
Sertoli cell
Which type of testicular tumour can present with precocious puberty?
Leydig cell
What is flat urothelial carcinoma in situ?
Very high grade lesion with high risk of progression into invasive tumour
See reddish area
Which testicular germ cell tumour has clear polygonal cells and a lymohcytic inflitrate?
Seminoma
Which type of urinary stone is most likely to develop into a massive “staghorn calculus”?
Triple stone AKA Magnesium ammonium phosphate (Struvite)
What is the typical histological appearance of non-invasive papillary urothelial carcinoma?
Frond-like growths
What is the typical histological appearance of a seminoma?
Clear polygonal cells and lymphocytic infiltrate
Which kidney cancer has golden-yellow appearance with haemorrhagic areas
Clear Cell Renal Cell Carcinoma
How does clear cell look on histology?
Lots of clear cells (they’re literally clear)
Papillary adenoma vs Papillary Renal Cell Carcinoma in terms of size
Adenoma = <15 mm
Carcinoma = >15 mm
fragile, friable brown tumour - which kidney tumour?
Papillary Renal Cell Carcinoma
well-circumscribed solid brown tumour - which kidney tumour?
Chromophobe Renal Cell Carcinoma
Risk progressoin index used for Renal Cell Carcinoma
Leibovich Risk Model
How do UROTHELIAL CARCINOMAS (used to be called transitional cell carcinomas) present?
Haematuria
frond-like (leaf-like) growths - which renal tumour?
Non-Invasive Papillary Urothelial Carcinoma
Most common malignant tumour in M
Prostatic Adenocarcinoma (this is the malignant form of prostate tumours)
Testicular Germ Cell Tumours arise from what?
germ cell neoplasia in situ
Malignant type of Testicular Germ Cell Tumours
Post-Pubertal Teratoma
