Renal Neoplasia Flashcards
Four important renal benign tumors
Renal papillary adenoma
Renal fibroma
Angiomyolipoma
Oncocyoma
Important renal papillary adenoma details
Small, discrete, and usually only seen in autopsy
Usually papillary within the cortex
Important details for oncocytoma
Eosinophilic cells with prominent mitochondria
5% of resected specimens
Three important types of malignant renal tumor
Wilm’s Tumor
Renal Cell Carcinoma
Urothelial Carcinoma of the renal pelvis
Who gets Wilm’s tumors
Most common primary renal tumors of childhood
Pathogenesis of Wilm’s Tumor
Abberations of multiple loci on Chr. 11
Premalignant it is Nephroblastomatosis.
Multicentric foci of immature nephrogenic elements that can infiltrate walls of pelvis and calyces.
Morphology of Wilm’s Tumor
Large, Solitary, Well circumscribed
Soft, Homogenous
Tan/Gray
Includes different stages of nephrogenesis
Clinical presentation of Wilm’s Tumor
Large abdominal mass
Hematuria
Typically found as pain in abdomen following traumatic accident
Intestinal Obstruction, HTN
Who gets renal cell carcinoma
Adults
Male
60s, 70s
Risk factors for renal cell carcinoma
Smoking, Obesity, HTN, unopposed estrogen
Asbestos, Petroleum, Heavy Metals
Renal Failure
Autosomal dominant forms of renal cell carcinoma
Von Hippel-Lindau
Hereditary Clear Cell Carcinoma
Three kinds of renal cell carcinoma
- Clear Cell (unbalanced translocations of Ch. 3)
- Papillary Carc. (Trisomy or loss of Y in male pt.)
- Chromophobe renal carc. (grow from intercalated cells of colelcting ducts)
Morphology of renal cell carcinoma
Mostly in poles, esp. upper
Bright yellow-gray-white spherical masses
Large areas of necrotic, Cystic and Hemorrhagic tissue
Fungates into ureter and extends into renal vein
Describe morphology seen specifically in clear cell renal carcinoma
Round/Polygonal with clear cytoplasm
Stain for glycogen and lipids
They have delicate branching vasculature
Clinical features of renal cell carcinoma
Hematuria, costovertebral pain, palpable mass
Discovered late with appearance of fever, malaise, weakness
Paraneoplastic Symptoms
Defining character with papillary carcinoma
psammoma bodies
Paraneoplastic symptoms associated with renal cell carcinoma
Polycythemia, Hypercalcemia, HTN
Hepatic Dysfxn, Sex hormone probs, Cushing
Eosinophillia/Leukmoid Rxns
renal cell carcinoma is especially prone to metastasize to
Lungs
Bones
Adrenals
Liver
Early symptomology of Urothelial carcinoma of renal pelvis
Obstruction, hematuria, fragmentation of tumor
Urothelial carcinoma of the renal pelvis is associated with…
Analgesic nephropathy
Three descriptive terms Kreisle gave for a Wilms tumor that outgrows its blood supply
Cystic, Necrotic, Hemorrhagic
