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Bloc D - Renal > Jan15 M3-Pathology of Bladder and Kidney > Flashcards

Jan15 M3-Pathology of Bladder and Kidney Flashcards

1
Q

most common type of bladder tumor

A

urothelial/transitional cell neoplasms

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2
Q

risk factors for bladder CA

A

smoking, radiation, analgesics, arylamines (petroleum, paint)

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3
Q

symptoms of bladder CA

A

painless hematuria, frequency, urgency, dysuria

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4
Q

2 ureteral orifice possible involvements in bladder CA

A

pyelonephritis

hydronephrosis

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5
Q

urothelial lesion invasive vs non invasive

A

invasive = beneath the BM

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6
Q

initial investigations for bladder CA suspicion

A

cystoscopy and cytology

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7
Q

temporary and permanent treatments of CA

A

temporary is resect visible tumors on cystoscopy.

definitive therapy based on histology

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8
Q

why do cytology + limitation of it

A

check for malignant cells. but won’t know where they’re from

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9
Q

cystectomy def

A

remove bladder

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10
Q

treatment options for urothelial lesions

A
  • removal of tumor + intravesical therapy
  • partial cystectomy
  • total cystectomy
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11
Q

intravesical therapies (2)

A
  • chemo

- BCG (weakened bacillus fof TB: induces intense T cell rx)

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12
Q

normal histo of the bladder

A
  • adipose tissue
  • muscular propria (SM): detrusol muscle
  • LP (fibroblasts and CT)
  • urothelium
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13
Q

2 types of non invasive urothelial lesions

A

flat and papillary

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14
Q

2 lesions that lead to invasive CA (one flat and one papillary)

A 
flat = CIS
papillary = papillary carcinoma, high grade (HGTCC = high grade transitional cell carcinoma)
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15
Q

papillary lesion charact

A

tree with branches being vessels feeding the neoplasm

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16
Q

charact of a benign urothelium

A

polarized cells, organized, translucid nuclei (not hyperchromatic), all same size and shape, no mitosis

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17
Q

4 non-invasive flat urothelial lesions

A
  • hyperplasia
  • reactive atypia
  • dysplasia
  • CIS
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18
Q

4 non-invasive papillary urothelial lesions

A
  • papilloma
  • punlmp (lmp = low malignant potential)
  • pap CA low grade (LGTCC)
  • pap CA high grade (HGTCC)
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19
Q

LGTCC histo

A

MILD: loss of polarity, hyperchromatic nuclei (some), rare mitosis

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20
Q

HGTCC charact histo + specific one

A

total loss of polarity, pleimorphism

*prominent nucleoli

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21
Q

CIS vs HGTCC on cystoscopy

A

CIS: hemorrhagic patch
HGTCC: papillary lesion

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22
Q

CIS on histo

A

cells still above BM but mitoses, hyperchromasia, prominent nucleoli, loss of polarity

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23
Q

CIS and HGTCC are non invasive. name when become invasive

A

invasive urothelial CA

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24
Q

pT1, pT2 and pT3 staging of urothelial CA

A

1: reached LP
2: reached muscle
3: reached adipose tissue

25
what urothelial lesions get resection only (+ follow up cysto/cyto)
papilloma, punlmp, LGTCC
26
what urothelial lesions get resection (TURB) + intravesical med (+ follow up cysto/cyto)
CIS, HGTCC, pT1
27
what urothelial lesions get surgery (cystectomy)
pT2, pT3
28
recurrence and progression of papillary lesions
papilloma and pnlump: low LGTCC: 50% recurrence low progression HGTCC: 50% recurrence 40% progression (to invasive)
29
2 benign renal epithelial tumors
oncocytoma | papillary adenoma
30
3 malignant renal epithelial tumors
conventional RCC papillary RCC chromophobe RCC
31
kidney CA risk factors
95% sporadic: smoking, obesity, htn | 5% familial: VHL syndrome (von hipper lindau syndrome)
32
other name for conventional RCC
clear cell RCC
33
VHL syndrome charact
hemangioblastomas of cerebellum and retina, liver+pancreas+renal cysts, clear cell RCC
34
typical syndrome where get conventional or clear cell RCC
VHL syndrome
35
presentation of kidney CA
asymptomatic 90% | 10% hematuria, CVA pain, palpable mass (all three together)
36
classic triad of kidney CA presentation (10% of the time)
hematuria, CVA pain, palpable mass
37
other presentations for kidney CA
paraneoplastic, general symptoms (fever, weight loss)
38
one word to describe clear cell RCC macro
heterogenous (bc solid mixed with cystic, hemorrhagic, necrotic, lipidic and yellow, brown and hemorrhagic)
39
two things on clear cell RCC micro
clusters of malignant cells with distinct membranes + network of capillaries between them
40
Fuhrman grading and which is bad
1 to 4 grading for nuclear atypia. | 3-4 is bad. 3 is prominent nucleoli
41
papillary RCC derived from what cells
PCT, DCT, CD cells
42
charact of papillary RCC + who gets it most commonly
- sporadic or hereditary - has the most cases of bilaterality/multifocality - most common in long-term hemodialysis pts
43
papillary RCC macro
no yellow. encapsulated. mainly hemorrhagic
44
papillary RCC micro
papillary structures lined by malignant tubular cells
45
papillary RCC type 1 vs type 2
1: 1 layer of cubidal cells 2: many layers of columnar cells. 2 is bad
46
RCC with best prognosis
chromophobe RCC
47
chromophobe RCC micro features
binucleated, halos around nuclei, eosinophilic cytoplasm, irreg membranes
48
main features of RCCs covered + which is worse which is best
clear cell (worst): presence of clear cells papillary: architecture chromophobe: best
49
oncocytoma macro
orange. rim of kidney parenchyma. no hemorrhage, no necrosis
50
oncocytoma micro
eosinophilic. nests of cells + hypocellular hyalinized edematous stroma
51
angiomyolipoma charact + type of kidney CA
dysmorphic blood vessels, myoid cells, adipose tissue. | Benign
52
angiomyolipoma associated with what
tuberous sclerosis
53
angiomyolipoma: when to resect
when risk of retroperitoneal bleeding
54
RCC: where does it spread and in what way does it try to reach out of the kidney
spreads centrally to the hilum. tries to go to renal vein
55
advanced RCC reaches where
renal vein
56
clear cell associated with what
VHL
57
tuberous sclerosis associated with what
AML (benign)
58
best RCC
chromophobe
59
2 types of papillary RCC and prognosis
2 is the bad one. 1 is layer cuboidal 2 is many layers colimnar + acidophilic cytoplasm + nucleoli

Bloc D - Renal (32 decks)

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