Path 3 Renal and Bladder Tumors Flashcards
Renal Papillary Adenoma
Bening tumor of Renal Tubular Epithelium
Renal Papillary Adenoma histo
Complex, branching, papillomatous structures (typical adenoma)
Oncocytoma
Benign tumor of Collecting Duct Intercalated Cells
Oncocytoma gross, histo
Well circumscribed with central scar
-Large eosinophilic epithelial cells (numerous mitochondria)
Angiomyolipoma
Benign tumor of vessels, muscle, and fat
- Tuberous Sclerosis association
- Bleeds spontaneously
Tuberous Sclerosis
Loss of function of TSC tumor suppressor gene
- Cerebral Cortex lesions, Epilepsy, Mental Retardation
- SEGA (subependymal giant cell angiosarcoma)
- Angiofibromas, Rhabdomyomas, Angiomyolipomas
Renal Cell Carcinoma causes
Most common malignant tumor
- Tobacco use
- Chronic renal failure, acquired cystic disease, tuberous sclerosis
Familial causes of Renal Cell Carcinoma (3)
- VHL disease (renal cysts, multiple bilateral RCCs)
- Hereditary (familial) Clear Cell Carcinoma (same gene as VHL)
- Hereditary Papillary Carcinoma (MET proto-oncogene mutation)
Von Hippel-Lindau disease
Deletion of VHL on ch. 3p
- Multiple Clear cell renal carcinomas
- CNS & retinal hemangioblastomas
Renal cell carcinoma typical features
Arise in poles of kidney
-Invade renal vein
Clear Cell Carcinoma
95% are sporadic
- Mutation on chromosome 3
- Polygonal cells containing glycogen and lipid
Papillary carcinoma
Associated with dialysis cystic disease
-Frequently multifocal
Papillary carcinoma histo
Psammoma bodies
-Foamy macrophages
Chromophobe renal carcinoma
Excellent prognosis
Chromophobe renal carcinoma histo
Distinction from oncocytoma difficult
- Eosinophilic cytoplasm with halo around nucleus
- Prominent cell membranes
Collecting (Bellini) duct carcinoma histo
Nests of malignant cells in medullary fibrotic stroma
-Irregular channels
Renal cell carcinoma clinical
- Costovertebral pain
- Palpable Mass
- Hematuria
Renal cell carcinoma metastasis locations
Lungs (50%)
Bones (30%)
Urothelial Carcinoma of Renal Pelvis clinical
- Clinically apparent quickly (obstruction, hematuria)
- Poor prognosis
- 50% preexisting bladder tumor
Urothelial carcinoma cause
Analgesic nephropathy
Preexisting bladder urothelial tumor
Urothelial bladder carcinoma clinical
Prognosis depends on invasion of muscularis propria (detrusor muscle)
Urothelial bladder carcinoma precursors
- Non-invasive papillary tumor (reg, inverted)
- Flat non-invasive urothelial carcinoma
Bladder papillary tumor Tx
Excision
Low grade papillary urothelial carcinomas
-Can recur and invade
High grade papillary urothelial carcinoa
80% invade into muscularis
-May produce fistulas
Pagetoid spread
Flat urothelial carcinoma (in situ)
Squamous cell carcinoma of the bladder
Shistosomiasis
Adenocarcinoma of the bladder
Urachal remnants or extensive intestinal metaplasia
Bladder cancer etiology (5)
- Tobacco
- Arylamines
- Schistosoma
- Analgesics
- Cyclophosphamide (immunosuppressant)
Bladder cancer clinical
Painless hematuria
-Tendency for higher grade recurrence after excision
Bladder cancer Dx
Urine FISH
Cytoscopy & biopsy
Bladder cancer Tx
Excision
- Intravesicular BCG to prevent recurrence
- Radical cystectomy for invasive cancer
Urethral caruncle
-Painful inflammatory lesion of urethra in older females
Peyronie disease
Fibrous bands involving corpus cavernosum
