Pathology 2 Flashcards
What is agenesis?
absence of one or both kidneys
What is hypoplasia of the kidneys?
small kidneys but normal development
What are horseshoe kidneys?
fusion at either pole- usually inferior
What is a duplex kidney?
kidney with more than one ureter
What are simple cysts?
very common, usually no functional disturbance
What happens in infantile type polycystic?
uniform bilateral renal enlargement, elongated cysts with dilatation of medullary collecting ducts; no gross distortion of the kidney
What is the inherintance of infantile polycystic kidneys?
autosomal recessive
What are infantile polycystic kidneys associated with?
congenital hepatic fibrosis
What is the inheritance of adult polycystic disease?
autosomal dominant
When does adult polycystic disease usually present?
middle adult life
What does adult polycystic disease present with?
abdo mass; haematuria; HT; CRF
What is seen with adult polycystic disease?
massive bilateral renal enlargement; mulitple cysts of varying size- distortion of reniform shape
What is adult polycystic disease associated with?
cysts in liver, pancreas and lung; Berry aneursysms in circle of willis
What does a berry aneurysm result in?
subarachnoid haemorrhage
What ar ethe types of benign renal tumours?
fibroma; adenoma; angiomyolipoma; JGCT
Describe fibromas?
common white nodules originating from the medulla
Describe adenomas?
yellowish nodules <2cm of cortical origin
Describe angiomyolipomas?
mixture of fat; muscle and blood vessels- can be mulitple and bilateral
What disease are angiomyolipomas assocaited with?
tuberous sclerosis
What does JGCT stand for?
juxtaglomerular cell tumour
What do JGCTs cause?
secondary HT due to production of renin
What are the types of malignant renal tumours?
nephroblastoma; urothelial carcinomas; renal cell carcinoma
What do nephroblastomas arise from?
residual primitive renal tissue
How do nephroblastomas present?
abdominal mass in child
Where do renal cell carcinomas arise from?
renal tubular epithlium
What is the commonest primary renal tumour in adults?
renal cell carcinoma
How does renal cell carcinoma present?
abdo mass; haematuria; flank pain
What can be seen on bloods with renal cell carcinoma?
polycythaemia; hypercalcaemia (ectopic PTH)
Who gets renal cell carcinomas?
55-60 years; M:F 2:1
How do renal cell carcinomas appear pathologically?
large well circumscribed mass in cortex; yellow with solic, cystic, necrotic and haemorrhagic areas
What indicates bad prognosis with RCC?
renal vein extension- can extend into vena cava to RA
How does RCC first spread?
blood
What is the commonest type of RCC?
clear cell type
Where is transitional epithlium present in the urine system?
pelvicalycael system to urethra
What is the commonest bladder tumour?
transitional cell carcinoma
What is the commonest symptom of TCC?
haematuria
Where do the majority of TCCs arise?
trigone- ureteric obstruction
What is the difficulty with TCCs?
recurrence is frequent
What is the commonest malignent bladder tumour in children?
embryonal rhabdomyosarcoma
When do squamous carcinomas arise?
post calculi (squamous metaplasia)