Histopathology - Urological pathology Flashcards
What is the most common composition of urinary calculi?
Calcium oxalate
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?
A consequence of infection with urease-producing organisms - Proteus, Klebsiella, Pseudomonas, and Staphylococcus species
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?
Benign epithelial kidney tumour composed of papillae and/or tubules
ALWAYS 15MM OR LESS IN SIZE
What is a renal oncocytoma? Why syndrome can they be seen in
Benign epithelial kidney tumour composed of oncocytic cells
Birt-Hogg-Dube syndrome
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
In what condition are angiomyolipomas most likely to appear?
Tuberous sclerosis
What is a renal cell carcinoma?
Malignancy of epithelial cells of kidney
What is the main symptom of renal cell carcinoma?
Painless haematuria
What is the most common subtype of renal cell carcinoma? What are the other types
Clear cell renal cell carcinoma
(other types = papillary cell + chromophobe)
What is the genetic association of clear cell carcinoma? What other condition is it linked to
Loss of chromosome 3p
von hippen Lindau
What is Nephroblastoma also known as?
Wilm’s tumour
What is nephroblastoma?
Triphasic kidney tumour of childhood
How does nephroblastoma typically present?
Abdominal mass in children aged 2-5
most common bladder tumour
Transitional cell (Urothelial) carcinoma - 90% of all bladder cancers 3x more common in males,
What are the 2 main treatments of BPH?
5 alpha reductase inhibitors (finasteride) Alpha blockers (tamsulosin)
What score is used for prostatic adenocarcinoma?
Gleason score
X (worst pattern) + Y (most common pattern) = Z
What is the most common type of testicular tumour?
95% = germ cell
Recall 2 risk factors for testicular germ cell tumours
Undescended testes
Low birth weight
What are the 5 histological subtypes of germ cell testicular tumour?
Seminoma
Embryonal carcinoma
Post-pubertal teratoma
Yolk Sac Tumour
Choriocarcinoma
seminal fluid, become and embryo, go through puberty, eat eggs for breakfast now you do chores
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
Which testicular germ cell tumour has clear polygonal cells and a lymohcytic inflitrate?
Seminoma (most common of them)
Which type of urinary stone is most likely to develop into a massive “staghorn calculus”?
Triple stone
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
histological feature of primitive tumours seen in Wilm’s too
small round blue cells
also Ewing’s sarcoma of bone
3 genetic associations of papillary adenoma
trisomy 7
trisomy 17
loss of y
what bladder cancer is linked to schistosomiasis
SCC
3 broad groups of malignant renal tumours
RCC
Nephroblastoma
Tranditional cell carcinoma
3 benign kidney tumours
papillary adenoma
oncocytoma
angiomyolipoma
give a beningn and a maligantnt postatic tumour
, presents with LUTS symptoms, suregrical option is TURP
malignant = porstae adenocarcinoma - arises from PIN (like CIN for boys)