Neoplasms of the Kidney Flashcards
What renal cancer shows up as mahogany brown on cut surface?
- Renal oncocytoma
Who most likely has renal cell carcinomas?
- Older individuals usually in the sixth and seventh decades
- More common in men
What renal abnormalities are seen in Von-Hippel Lindau syndrome?
- Renal cysts
- Often bilateral, multiple renal cell carcinomas
What causes hereditary leiomyomatosis and renal cell cancer syndrome?
- Autosomal dominant caused by mutations of the FH gene (fumarate hydratase)
What does hereditary leiomyomatosis look like?
- Cutaneous and uterine leiomyomata
- Aggressive type of papillary carcinoma with increased propensity for metastatic spread
What is hereditary papillary carcinoma?
- Autosomal dominant disorder
- Multiple bilateral tumors with papillary histology
What do the tumors look like in hereditary papillary carcinoma?
- Series of cytogenetic abnormalities
- Mutations in the MET proto-oncogene
What is Birt-Hogg-Dube syndrome?
- Autosomal dominant
- Mutations in the BHD gene –> expresses folliculin
What is seen in Birt-Hogg-Dube syndrome?
- Constellation of skin, pulmonary, and renal tumors with a wide range of histologic subtypes
What is a big risk factor for renal cell carcinoma?
- Cigarette smokers have double the risk
- Pipe and cigar smokers are also more susceptible
What are some additional risk factors for renal cell carcinoma?
- Obesity
- HTN
- Unopposed estrogen therapy
- Exposure to asbestos, petroleum products, and heavy metals
Where is renal cell carcinoma most likely found?
- Could arise in any portion but more commonly affects the poles
- May enlarge and bulge into the calyces and pelvis
- Eventually through the walls of the collecting system to extend into the ureter
Where does renal cell carcinoma usually invade?
- Venous tumor invasion (extension into the IVC)
How is tumor thrombus distinguished from bland thrombus?
- Contrast enhancement on CT and MRI
- Color flow on U/S
