Renal Cancer NM

Question 1

RCC T

Answer 1

Question 2

RCC N

Answer 2

Renal hilar
Caval
Aortic LN

Question 3

RCC M

Answer 3

Lung
Bone - - lytic
Liver
Adrenal
17% present with MTS

Question 4

RCC paraneoplastic

Answer 4

Hypertension
Polycythemia
Hepatic dysfunction (Stauffer sy)
Amyloidosis
Neuromyopathy, Cushing, galactorrhea

Question 5

RCC risk

Answer 5

Von Hippel Landau
Tuberous Sclerosis
Hereditary leiomyomatosis 17% type 2 papillary RCC
Sickle cell trait rare renal medullary ca, poor prognosis, MTS
Birt-Hogg-Dube chromophobe RCC

Question 6

Von Hippel Landau

Answer 6

24-45% RCC clear cell bilateral
Pancreatic cyst and NET
Pheo
Retinal angioma

Question 7

Tuberous Sclerosis

Answer 7

2-4% clear cell RCC
34-80% angiomyolipoma - - India ink artifact
CNS, thoracic, derma findings

Question 8

RCC type

Answer 8

Clear cell 65-80% - arterial enhancement, high T2
Papillary 10-15% - slow enhancement, low T2
Chromophobe 4-11% - middle enhancement, intermediate T2, central scar

Question 9

Radical nephrectomy

Answer 9

T1-2 GFR >45
Kidney, adrenal, peri renal fat, fascia Gerota, LN
<3 cm lesion - - thermal ablation

Question 10

T3 treatment RCC

Answer 10

Radical resection, EBRT, arterial embolization

Question 11

Most avid FDG

Answer 11

Papillary type 2 RCC esp in case of hereditary leiomyomatosis and RCC syndrome
Main indication - - RCC resectable with solitary MTS

Question 12

TCC of Upper tract M

Answer 12

Liver
Lung
Bone
GIT
Peritoneum

Question 13

TCC of Upper tract risk

Answer 13

Smoking
Coffee >7 cups a day
Cyclophosphamide chemotherapy
Balkan nephropathy
Horseshoe kidney

Question 14

TCC of Bladder T

Answer 14

Question 15

TCC of Bladder N3

Answer 15

Common iliac LN

Question 16

TCC of Bladder M

Answer 16

Liver
Lung
Bone (lytic pelvis, spine)
Peritoneum

Question 17

Recurrent TCC risk

Answer 17

Deep bladder wall invasion
Tumor >3 cm
Multiple lesions
Hydronephrosis
Lamina propria invasion
Prostate involvement

Question 18

Urethral carcinoma T4

Answer 18

Bladder wall invasion
Stage IV

Question 19

Fluorothymidine = F-FLT

Answer 19

Cell proliferation marker
Correlated with Ki67
Predict more aggressive RCC

Question 20

F-Fluoride

Answer 20

More sensitive than bone scan in lytic MTS

Question 21

F-FMISO

Answer 21

Assessment of tissue hypoxia
Modest uptake in RCC, not predictive of response to therapy

Question 22

C tracers for Bladder cancer

Answer 22

No urinary excretion
Choline - cell proliferation, no uptake in premalignant lesion or small non invasive tumor
Methionine - amino acid transport, peak uptake at 10 min
Acetate - similar accuracy as MRI and CT

Question 23

RCC stage III

Answer 23

N1

Question 24

Renal pelvis SCC

Answer 24

Ass with xanthogranulomatous pyelonephritis

Question 25

Answer 25

RCC

Question 26

Bladder cancer risk

Answer 26

Smoking
Industrial carcinogens
Arsenic in water
Recurrent UTI and stones
Shistosoma hematobium

Question 27

Renal angiomyolipoma

Answer 27

Involve cortex
Macroscopic fat content HU <-20
Similar to simple cyst
TS - - multiple