Pathology of GU Neoplasms

Question 1

The greatest risk factor for urothelial neoplasms

Answer 1

Tobacco use

Question 2

Most important usual clinical presentation of urothelial neoplasms

Answer 2

Hematuria

Question 3

type of malignant urothelial cancer; non-invasive mass that has undulating, finger-like projections

Answer 3

Papillary urothelial carcinoma, non-invasive

Question 4

type of malignant urothelial cancer; high grade non-invasive flat tumor; flat and erythematous with no discrete mass; malignant cells shed into urine

Answer 4

Urothelial Carcinoma In Situ

Question 5

type of malignant urothelial cancer; invasive tumor (T1-T4); most are high grade

Answer 5

Invasive Urothelial Carcinoma

Question 6

a rare bladder tumor that is most common worldwide (not in US) due to its association with schistosomiasis

Answer 6

Squamous cell carcinoma

Question 7

What can be histologically found in invasive squamous cell carcinoma of bladder?

Answer 7

Schistosoma eggs (calcified ) within the tumor

Question 8

Neoplasms due to MALIGNANT transformation of germ (spermatogenic) cells; most common testicular cancer (95%); painless solid mass; increased risk with cryptorchidism

Answer 8

Germ Cell Neoplasms

Question 9

What tumor markers are useful for diagnosing germ cell testicular cancers

Answer 9

AFP (Alpha Fetoprotein; yolk sac differentiation)
HCG
LDH (Lactic Dehydrogenase; bulky tumors)

Question 10

Benign neoplasm that arise from Sertoli and Leydig cells; lack of germ cell markers (because it doesn’t involve germ cells); spindly cells can be seen histologically

Answer 10

Sex Cord-Stromal Neoplasms

Question 11

Two types of testicular germ-cell tumors

Answer 11

1. Seminoma
2. Non-Seminomatous
   - Embryonal Carcinoma
   - Yolk Sac Tumor
   - Choriocarcinoma
   - Teratoma

Question 12

Most common testicular germ-cell tumor; gross appearance of solid, white intra-testicular mass; histologic findings of large tumor cells with lymphocytes; AFP and BHCG negative with LDH elevation

Answer 12

Seminoma

Question 13

type of testicular, germ-cell tumor; commonly involve necrosis and hemorrhage; + specific tumor markers (AFP, BHCG and LDH)

Answer 13

Non-Seminomatous Germ Cell

Question 14

Match types of non-seminatous germ-cell tumor with its tumor marker

Answer 14

1. Yolk Sac Tumor (AFP+)
2. Choriocarcinoma (HCG +; trophoblastic differentiation)
3. Teratoma (AFP & HCG -; good prognosis; somatic differentiation)
4. Embryonal Carcinoma (AFP & HCG -; more aggressive, undifferentiated cells)

Question 15

Which non-seminatous germ-cell tumor is commonly seen in metastatic sites after chemo?

Answer 15

Teratoma

Question 16

Mixed germ-cell tumors are usually a mix of what tumors?

Answer 16

Embryonal carcinoma and teratoma

Question 17

first occupational disease associated with a chemical carcinogen (chimney sweeps and soot exposure)

Answer 17

squamous cell carcinoma in situ

Question 18

seen much more in uncircumcised men; usually associated with poor hygiene or HPV 16, 18; can spread to inguinal lymph nodes

Answer 18

Penile Squamous Cell Carcinoma

Question 19

Most common type of bladder cancer

Answer 19

urothelial carcinoma

Question 20

The most common presenting sign for bladder cancer

Answer 20

painless gross or micro hematuria

Question 21

Bladder cancer diagnosis testing

Answer 21

cystoscopy
CT urogram
Urine cytology

Question 22

Bladder cancer tx

Answer 22

Non-invasive –> TURBT, intravesical therapy

Invasive/Metastatic –> chemo/radiation

Question 23

What is the best testing after finding a lump on a testicle?

Answer 23

Scrotal u/s

Question 24

Testis cancer tx

Answer 24

almost always orchiectomy +/- radiation/chemo

Question 25

Survival rate of testis cancer (seminoma and non-seminoma)

Answer 25

very high!

95-98%

Question 26

Penile cancer tx

Answer 26

1. control primary tumor (surgery)
2. treat infection (antibiotics)
3. treat lymph nodes (inguinal lymph node dissection)
4. radiation/chemo