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Renal Pathology > Neoplasms > Flashcards

Neoplasms Flashcards

1
Q
A

Renal Papillary Adenoma

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2
Q
A

Angiomyolipoma

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3
Q

Deletions on Chromosome 3

Loss of VHL

Inactivated Mutated VHL

Hypermethylation of VHL

A

Sporadic Clear Cell

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4
Q

Deletions on Chromosome 3

Loss of VHL

Inactivated Mutated VHL

Hypermethylation of VHL

A

Hereditary Clear cell

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5
Q

Trisomy 7

Mutated Activated MET

A

Hereditary Papillary

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6
Q

Trisomy 7, 17

Loss of Y

Mutated activated MET

A

Sporadic Papillary

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7
Q
A

Clear Cell

  • Cells with lipid-rich ample cytoplasm.
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8
Q
A

Type 1 Papillary

  • Small basophilic cells with scarce cytoplasm, organized in a spindle- shaped pattern, in a single layer of cells surrounding the basal membrane.
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9
Q
A

Renal cell carcinoma, gross.

  • Location: lower pole.
  • Circumscribed
  • Hemorrhagic red and cystic areas.
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10
Q
A

Papillary Renal cell carcinoma, gross.

• Cystic with extensive hemorrhage

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11
Q
A

Renal cell carcinoma, microscopic

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12
Q
A

Large Papillary Tumor

  • Papillary pattern
  • Circumscribed.
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13
Q
A

High-grade invasive transitional cell carcinoma.
• Ulceration and necrosis.

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14
Q

Autosomal dominant hereditary neoplastic disorder characterized by the development of tumors in the cerebellum, spine, retina, inner ear, pancreas, adrenal glands, and kidneys).

A

Von Hippel Lindau

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15
Q

Renal Papilary Adenoma, Angiomyolipoma, Oncocytoma

A

Benign Neoplasms

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16
Q

Clear Cell Carcinoma, Papilary Renal Carcinoma, Chromophobe

A

Malignant Neoplasms

17
Q

Small,discrete adenomas arising from the renal tubular epithelium (more frequent papillary)

A

Renal Papillary Adenoma

18
Q

These are small tumors (usuallyl ess than 0.5cm in diameter)

They are present invariably within the cortex and appear grossly as pale yellow-gray discrete, well-circumscribed nodules.

A

Renal Papillary Adenoma

19
Q
  • This is a benign neoplasm consisting of vessels, smooth

muscle, and fat originating from perivascular epithelioid cells.

  • Present in 25% to 50% of patients with tuberous sclerosis (disease caused by loss-of-function mutations in the TSC1 or TSC2)
  • linical importance: susceptibility to spontaneous hemorrhage.
A

Angiomyolipoma

20
Q
  • Epithelial neoplasm composed of large eosinophilic cells.
  • Arise from the intercalated cells of collecting ducts.
  • Accounts for approximately 5% to 15% of renal neoplasms.
  • They may achieve a large size (up to 12 cm in diameter).
A

Oncocytoma

21
Q
  • Account for 85% of renal cancers in adults (3% newly diagnosed)
  • The tumors occur most often in older individuals (usually in the sixth and seventh decades of life).
  • 2 : 1 male preponderance
A

Renal Cell Carinoma

22
Q
  • Risk Factors:
  • Tobacco is the most significant risk factor.
  • Obesity (particularly in women)
  • Hypertension
  • Unopposed estrogen therapy
  • Exposure to asbestos
  • Petroleum products
  • Heavy metals.
  • Chronic kidney disease, acquired polycystic kidney disease and tuberous sclerosis.
A

Renal Cell Carcinoma

23
Q
  • Most common 70% to 80% of renal cell cancers.
  • 95% are sporadic.
  • They arise from the proximal tubule
  • Specifically Associated with Von Hippel Lindau syndrome.
A

Clear Cell Carcinoma

24
Q

Autosomal dominant hereditary neoplastic disorder characterized by the development of tumors in the cerebellum, spine, retina, inner ear, pancreas, adrenal glands, and kidneys).

  • Deleted region harbors VHL genes.
A

Von Hippel Lindau Syndrome

25
Q
  • Accounts for 10% to 15% of renal cancers.
  • It is characterized by a papillary growth pattern and occurs in both familial and sporadic forms.
  • The most common cytogenetic abnormalities are trisomies 7 and 17.
  • Mutations in MET
A

Papillary Carcinoma

26
Q
  • Represents 5% of renal cell cancers and is composed of cells with prominent cell membranes and pale eosinophilic cytoplasm.
  • Grow from intercalated cells collecting ducts (good prognosis)
A

Chromophobe Carcinomas

27
Q
  • May arise in any portion of the kidney, but more commonly affects the poles.
A

Renal Cell Carcinomas

28
Q
  • Most likely arise from proximal tubular epithelium, and usually occur as solitary unilateral lesions.
  • They are bright yellow-gray white spherical masses
  • Variable size.
  • The margins are usually sharply defined and confined within the renal capsule.
A

Clear Cell Carcinomas

29
Q
  • Only 10% of cases
  • Costovertebral pain, Hematuria, Palpable mass
  • Most reliable clue: Hematuria Intermittent
  • Microscopic; thus, the tumor may remain silent until it attains a large size, often greater than 10 cm.
  • Associated with generalized constitutional symptoms: fever, malaise, weakness, and weight loss.
A

Renal Cell Carcinoma

30
Q
  • Polycytemia from elaboration of erythropoietin.
  • Hypercalcemia with tumor production of parathormone-related peptide.
  • Steroid hormone release with Cushing syndrome, feminization, or masculinization.
A

Paraneoplastic Syndromes Related To Renal Cell Carcinomas

31
Q

What are the most common locations of methastasis?

A
  1. Lungs (50%)
  2. Bones (33%)
  3. Regional lymph nodes, liver, adrenal, and brain.
32
Q

Treatment of choice to Renal Cell Carcinomas?

A

- Radical nephrectomy

  • Partial nephroctomy if tumor is smaller than 4 cm
33
Q
  • Most common renal malignancy in children.
  • Age 2- 4
  • Deletion of WT1 or WT2 chromosome 11
  • Clinical Presentation:
  • Flank mass
  • Hematuria
  • Abdominal pain, fever (less common).
A

Wilms Tumor

34
Q
  • 90% of all bladder tumors. 􏰁
  • Multifocal at presentation.
  • *􏰁 Two Precursor lesions:**
  • Noninvasive papillary tumors (Originate from urothelial hyperplasia).
  • Flat noninvasive urothelial carcinoma. (Carcinoma in Situ or CIS).
A

Urothelial/Transitional Tumors

35
Q
  • Incidence is higher in men than in women. 3:1
  • Higher in developed than in developing nations and in urban than in rural dwellers.
  • 50 and 80 years of age (not familial, rare exceptions).

Risk Factors:

  • Cigarette smoking (the most important).
  • Industrial exposure to aryl amines (2 naphthylamine)
  • Schistosoma haematobium infections in endemic areas (Egypt, Sudan).
  • Chronic inflammatory response
  • Mucosal squamous metaplasia
  • Long-term use of analgesics
  • Heavy long-term exposure to cyclophosphamide,
  • Radiation.
A

Urothelial/Transitional Tumors

36
Q

Name the sites to where the aggressive bladders tumors can extend?

A

Bladder Wall

Adjacent Prostate

Seminal Vesicles

Ureters

Retroperitoneum

37
Q
  • Painless Hematuria
  • Frequency, urgency, and dysuria occasionally accompany the hematuria.
  • When the ureteral orifice is involved, pyelonephritis or hydronephrosis may follow.
A

Clinical Manifestations of Bladders Tumors

38
Q

What are the prognosis of Bladder Tumors?

A
  • 98% 10 year survival rate
  • Invasive urothelial carcinoma is associated with a 30% mortality rate once tumor invades into the lamina propria.

Renal Pathology (4 decks)

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