Lec 8 Male GU

Question 1

What is major kidney tumor of kids?

Answer 1

wilms tumor = peaks 3-4 yo

Question 2

What are characteristics of wilms tumor [nephroblastoma]?

Answer 2

• seen in kids 2-5 yo
• containes embyonic glomerular structures
• present palpable flank mass and hematuria

Question 3

What mutations associated wtih wilms tumor?

Answer 3

mutations of tumor suppressor genes WT1 or WT2 on chr 11

Question 4

What pattern do you see in wilms tumor histologically?

Answer 4

triphasic pattern = epithlium, mesenchyme, blastema

Question 5

What are unfavorable histo findings in wilms tumor?

Answer 5

• anaplastic nuclear changes (hyperchromatic nuclei, mitoses)

Question 6

What in an oncocytoma?

Answer 6

benign epithelial cell tumor

Question 7

What happens when you detect renal cell carcinoma?

Answer 7

do curative surgery w/out diagnostic biopsy; treatment of choice = partial nephrectomy

Question 8

What is major adult renal tumor?

Answer 8

clear cell renal carcinoma

Question 9

What do you see grossly in oncocytoma?

Answer 9

solid mahogany tumor with central scar

Question 10

What do you see on histology in oncocytome?

Answer 10

granular eosinophilic cytoplasm
uniform round nuclei
prominent nucleoli
abundant mitochondria without perinuclear clearing

Question 11

What do you see grossly in clear cell RCC?

Answer 11

solid or cystic variegated tumor

yellow to red

Question 12

What do you see grossly in papillary RCC?

Answer 12

solid or cystic variegated tumor

tan to brown

Question 13

What do you see grossly in chromophobe RCC?

Answer 13

solid tan tumor

Question 14

What do you see on histology in clear cell RCC?

Answer 14

clear or eosinophilic cytoplasm

rich capillary network

Question 15

What do you see on histology in papillary RCC?

Answer 15

papillary or solid eosinophilic cells

Question 16

What do you see on histology in chromophobe RCC?

Answer 16

flocculent clear or eosinophilic cells
distinct cell borders
look like koilocytes

Question 17

What genetics associated wtih clear cell RCC?

Answer 17

deteltion on chr 3 [VHL]

Question 18

What is survival rate for papillary RCC?

Answer 18

80-85% 5 year survival

Question 19

What is translocation associated RCC?

Answer 19

seen in younger pts; have aggressive behavior

histoloogy = papillary architecture with clear cells

Question 20

What is major type of urinary tract tumor?

Answer 20

95% of urothelial origin = urothelial carcinoma or transitional cell carcinoma

Question 21

how do urinary tract tumors present?

Answer 21

age > 50

hematuria, urinary obstruction

Question 22

How do you classify urothelial lesions?

Answer 22

papillary vs flat
high grade vs low grade
non-invasive vs invasive

Question 23

What do you see in papillomas of bladder?

Answer 23

simple papillary struct liked wtih normal urothelium

Question 24

What is most common urinary tract tumor?

Answer 24

low grade papillary urothelial carcinoma

Question 25

What do you see in low grade papillary urothelial carcinoma?

Answer 25

papillary pattern mild cytologic atypia high recurrence rate (55-65%)

Question 26

What do you see in high grade papillary urothelial ca?

Answer 26

marked cytologica atypia | 15-40% progress to invasive

Question 27

What are characteristics of flat urothelial carcinoma in situ?

Answer 27

``` flat high grade lesion appears velvety on cytoscopy associated wtih invasive carcinoma poorly cohesive cells often shed into urin ```

Question 28

What mutations in high grade or CIS non-invasive?

Answer 28

P53 and Rb

Question 29

What are treatment implications for low vs high grade tumors?

Answer 29

low = follow up, tumor resection | high grade or invasive = resect, biotherapy, chemo

Question 30

What kind of cancer is associated with schistosoma infection?

Answer 30

squamous cell carcinoma of bladder

Question 31

What do you see microscopically in BH?

Answer 31

nodular proliferation of normal glands, stroma, or both

Question 32

Where does cancer vs BPH localize in prostate?

Answer 32

cancer = peripheral, ill defined border, yellow discoloration BPH = transitional zone / periurethral, nodular, whitish

Question 33

What is hallmark of benign vs carcinoma of prostate?

Answer 33

benign = no nuclear atypia, lobular, have basal cells carcinoma = nuclear atypia, loss of basal cells

Question 34

What is gleason grade 4?

Answer 34

fused or poorly formed glands

Question 35

What is gleason grade 5?

Answer 35

solid sheet, central necrosis, individual cells

Question 36

What does GS < 6 vs 7 vs 8-10 mean?

Answer 36

< 6 = well differentiated 7 = moderately differentiated 8-10 = poorly differentiated

Question 37

Where does prostate cancer met?

Answer 37

to bone = osteoblastic

Question 38

What is normal PSA?

Answer 38

< 2.5

Question 39

What do you see clinically in germ cell testicular tumor?

Answer 39

painless enlargement of testis; can successfully treat w/ radiation or chemo

Question 40

What associated with penile cancer?

Answer 40

HPV