Nephrology Tumors Flashcards
What are oncocytomas composed of?
- oncocytic cells (eosinophilic and granular cytoplasm)
What is a oncocytoma?
- benign epithelial neoplasm
What are angiomyolipoma composed of?
- blood vessels, smooth muscle, and adipose tissue (fat)
* benign neoplasm*
95% of all tumors originating in the kidney are what type?
- renal cell carcinoma
Where in the glomerulus do you most often find renal cell carcinomas?
- proximal convoluted tubule
* most metabolically active
What % of renal cell carcinoma are metastatic at presentation?
30%
What are some of the risk factors for renal cell carcinoma? (4 listed)
- smoking
- dialysis
- HBP
- obesity
What is the classic triad of symptoms consistent with renal cell carcinoma?
- Hematuria (90%)
- Flank/abdominal pain
- Palpable mass
A left sided varicocele may be indicative of what type of renal tumor?
- renal cell carcinoma
What is the mainstay treatment for renal cell carcinoma?
- radial nephrectomy
What are the 3 types of RCC?
- clear cell
- papillary
- chromophobe
What is the most common abdominal malignancy in kids?
- Wilm’s tumor
What is the typical presentation of Wilm’s tumor?
- painless palpable abdominal mass
T/F: 98% of Wilm’s tumors occur before the age of 10.
True
What is the mainstay treatment of Wilm’s tumor?
- nephrectomy followed by chemotherapy
* 80-90% cure rate
What are the stages of Wilm’s tumor and what do they represent? (4 total)
- Stage I = confined to kidney
- Stage 2 = beyond kidney
- Stage 3 = residual, non-hematogenous tumor in abd
- Stage 4 = hematogenous metastases, bilateral tumor
Wilm’s tumor is derived from what type of cells?
- nephrogenic blastemal cells
Which of the following urothelial neoplasias is benign?
a. papillary neoplasms
b. urothelial carcinoma in-situ
c. urothelial papilloma
d. invasive urothelial carcinoma
c. urothelial papilloma
Urothelial carcinomas most frequently occur in what organ?
- bladder
90% of bladder cancers involve what cells?
- transitional cells
* cells that line bladder allowing for expansion
What type of cancer has the highest rate of recurrence of all cancers?
- bladder cancer
What are the 2 main risk factors of bladder cancer?
- smoking
- > 60 yo
What chemo drug has been associated with an increased risk of bladder cancer?
- cyclophosphamide (hemorrhagic cystitis)
80-90% of patients with bladder cancer will present with this sign.
- painless microscopic or gross hematuria (80-90%)
How can you differentiate between bladder cancer and BPH?
- bladder cancer will result in dysuria
What diagnostic study is used for bladder cancers?
- cystoscopy
What genetic anomalies are associated with horseshoe kidney? (2)
- Turner’s syndrome
- Trisomy 13, 18, 21
80% of patients with horseshoe kidney present with this sign.
- Reflux
What is the etiology of reflux nephropathy?
- incompetent close of the UVJ
What is a horseshoe kidney?
- renal condition in which the inferior poles of the kidney are fused
If a child or male presents with an UTI they need to be evaluated for this congenital abnormality.
- Vesico-ureteral reflux
What diagnostic study is used to assess for vesico-ureteral reflux?
- Voiding Cystourethrogram (VCUG)
Exposure to aniline dyes and aromatic amines is a risk factor for what type of cancer?
- Urothelial Neoplasia
What is the clinical presentation of reflux nephropathy if it occurs prenatal vs postnatal?
- prenatal = hydronephrosis
- post-natal = UTI
What grade of reflux nephropathy requires treatment?
Grade 3+
