Hydronephrosis Flashcards
key to detemining TNM staging
whether muscularis propria invaded
most common benign tumor of kidney
most common complication of this tumor
angiomyolipoma (mesenchymal tumor)
hemorrhage complication
polypoid cystitis morphology
projections blunt/broad based,
best diagnosed at low power
grading of urothelial grading based on
nuclei arrangemen/polarity and invasion
61% of neprhogenic adenoma (nephrogenic metaplasia) arise following
GU surgery
associations medullary carcinoma
african or mediterranean descent
patients have sickle cell or sickle cell trait
worst outcome of all kidney cancers (1-7months)
morphology nephrogenic adenoma
benign proliferation of tubules, inflammatory cells
angiomyolipoma derived from
cell type with premelanosomes > stains positive with melanoma markers
papillary cystitis morphology
lined by urothelium
stroma has inflamm cells
patients with acquired cystic diseasse due to crhonic dialysis dependency have a 100x risk of
oxalate crystals
association, morphology Celar Cell tubulopapillary carcinoma
occurs in ESkidneys (cystic or non-cystic)
papillary cores lined by cells with clear cytoplasm and clei towards lumen apical surface
tight packed tubules
morphology clear cell type renal carcinoma
softening center of tumor = gelatinous necrosis (worsens outcome)
association upper urothelial tract orothelail carcinoma
mismatch repaire genes (as in Lynch syndrome)
instabilitity of at least two microstellite markers
presentation renal cell carcinoma
painless hematuria
palpable abdominal mass
dull flank pain
polycythemia in 10% due to EPO production by tumor (paraneoplastic syndrome)
morphology papillary type renal cell carcinoma (2 types)
tumor cells line finger like projection into stroma
prominent nuclei
blood vessess + macrophages
papilalry type 1 - thin papillae, small cuboidal
paillary type 2 - thick papilae, abundeant cytoplasma
differentiate pT1 vs pT2
muscularis propria involvement
morphology chromophobe carcinoma
normal glomerulus
circumscribed tumor
halo around wrinkled nuclei
binucleateed cells
metatasis rare
features of exophytic or papillary carcinoma to report on TURBT
invasive? (into lamina propria)
muscularis propria present?
precent involvement
necrosis
oncocytoma arises from
intercalated cells of colelctin duct
morphology collecting duct carcinoma
irregular aggregates of tumor cells
surrounded by endemetous desmoplastic stroma
large 6-11cm
metatasize early
morphology oncocytoma
gross - yellow brown with central scarring
LM - edematous stroma (white)
nests/islands of pink eosinophilic cytoplasm
renal cell carcinoma stagin
T1 -
T2 >7cm, confined to kidney
T3a - extend to fat of kidney capsule
T3b - extend to renal vein, pos to IVC
morphology angiomyolipoma
prominent vessels
muscle cells
bubbly vacuolated cells
common histo finding of carcinoma in situ due to distburbed cell-cell interaction
denuding cystitis - dicohesive cells
polypoid cystitis vs papillary cystitis
both arise with submucosal edema, inflammation
polypoid cystitis has more blunt projections, tip wider than base than papillary, which is more likely to mimc tumor
morphology hydronephrosis
cortex and medulla compressed to a rim
pelvicalyceal system dilated
morphology urothelial papilloma
minially branching delicate papillae with fibrobascualr core
lined with normal urothelium, no significant cytologic atypia
___% with carcinoma in situ develop biopsy proven cancer
often presents with bladder ulcerations mimicking some benign conditions
60%
common staging of upper urothelial tract urothelial carcinoma
most are high grade and locally advanced
(agressive, muscle wall is thin)
stages of TNM with no muscularis propria invasia
pTIS, pTa Pt1
morphology medullary carcinoma
atpyical cells with prominetn nuclei
subtle borders
necrosis as tumor outgrows blood supply
renal cell carcinoma nucleolar grading
Grade 1 - tiny dot nuclei
Grade 2 - nuclei variation, nucleoli inconspicuous
grade 3 nuclei appreciated at low power
grade 4 - bizarre cells
flat intra urothelial neoplasia morphology
loss of polarity
nuclear clustering
increased nuclear size
nuclear peoplmorphism
increased chromatin granularity
scattered nucleoli
wilms tumor components derived from
mesoderm
morphology cystitis cystica / glanularis
nest of cells
mucin developing cells > inflammation (PMNs)
risk of ancer in urothelial dysplasia
mildly increased (15%)
