Pathology to midterm

Question 0

Angiomyolipoma

Answer 0

F>M, from perivascular epithelioid cells; TSC1/2 muts

(assoc. w/ tuberous sclerosis, VHL,
* may cause life-threatening massive hemorrhage, high grade.
micro: high fat, sm. mm, & abnormal blood vessels, + melanocytic marker

Question 1

Oncocytoma

Answer 1

renal tumor of collecting duct intercalated cells
Gross: well-circumscribed, “mahogany brown”
Microscopic: increased mitochondria, bland nuclei, absence of mitotic figures

Question 2

Renal Cell Carcinoma clinical picture

Answer 2

most common renal neoplasm, esp. ages 60-70, M>F
Sx: hematuria, flank pain, palpable mass, fever, anemia, weight loss
*paraneoplastic syndromes: polycythemia, hyperCa, Cushing’s, etc.
Risk factors: tobacco, obesity, HTN, chronic renal failure, vonHippel-Lindau syndrome

Question 3

Renal cell carcinoma subtypes

Answer 3

80% clear cell carcinoma
10% papillary renal cell carcinoma
5% chromophobe renal carcinoma

Question 4

clear cell renal cell carcinoma mech & epidemiology

Answer 4

Molec mech: deletion of VHL gene (tumor suppressor) on chrom. 3
Epi: Most common renal carcinoma, M>F,
= from prox. tubular epithelium; esp found near renal vein.

Question 5

Clear cell renal carcinoma pathology

Answer 5

Gross: yellow-gold, variegated cut surface (bc hemorrhage, etc)
Micro: significant network of delicate capillaries, diverse/varied architecture, distinct cell membranes, clear cytoplasm
* CD10 +, vimentin +, cytokeratin7 -