Pathology of the Prostate and Tumors of the Kidney

Question 1

Nodular BPH path

Answer 1

• ## Hyperplasia of transitional zone projecting upward beneath urethral mucosa -> obstruction

Question 2

Adenocarcinoma of Prostate

• Pathogenesis
• Morph
• LabDx
• Spread

Answer 2

• PAth: Chromosomal rearrangement in ETS/TMPRSS2; MYC oncogene; TSG PNET + TP53; Hypermethylation; amplification of androgen receptor gene locus
• Morph: Dysplastic changes in peripheral zone; firm/gritty, poorly-defined yellow-gray lesions
• LabDx: PSA
• Spread: Lymph + Heme -> bone, lung, liver

Question 3

Gleason System

Answer 3

• 2-6 well differentiated
  7 mod diff
  8-1- poorly diff
• Grading of predominant changes + 2nd most common changes

Question 4

Renal Papillary Adenoma Morph

Answer 4

• Morph: >3 cm pale yellow-gray w. tubules, glands,m cords, etc

Question 5

Renal Oncocytoma morph

Answer 5

• Homogenous Tan/mahogany well-encapsulated up to 12 cm w. eosinophilic cells

Question 6

Renal angiomyolipoma Morph + concerns + A/S

Answer 6

• Tumor consisting of vessels, SmM, + fat
• May spontaneously hemorrhage
• A/S: Tuberous Sclerosis

Question 7

Renal Cell Carcinoma

• A/S
• Genetics

Answer 7

• A/s: Smoking; VHL, FCCC, HP RCCA

- G: RCCA gene syndromes

Question 8

Clear Cell RCCA Morph

Answer 8

• proximal tubular epithelium
• spherical masses
• solitary; unilateral
• bright yellow-gray-white tissue
• abundant glycogen + lipids

Question 9

Wilms Tumor

• A/S
• Morph

Answer 9

• A/S: Denys-Drash Syndrome
  WAGR syndrome
  Beckwith-Wiedemann syndrome
• Morph: Large tan/gray well-circumscribed tumor w. focal necrosis, hemorrhage, + cyst formation