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Nephrology > Renal Neoplasms > Flashcards

Renal Neoplasms Flashcards

1
Q

What are the gross Characteristics of adenoma

A

Pale yellow gray well circumcised nodules

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2
Q

Describe the histologic characteristics of adenoma

A

Peppa lemada structures with numerous complex fronds; cells are cubodial to polygonal With small central nuclei with little cytoplasm

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3
Q

We’re in the kidneys papillary adenoma Commonly found

A

Renal cortex

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4
Q

Adenoma is derived from what part of the kidney

A

renal tubular epithelium

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5
Q

Angiomyolipoma is derived from what renal structure

A

perivascular epithelioid cells

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6
Q

Angiogmyelipomas are commonly found in which population and why

A

women; These cells express estrogen receptors

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7
Q

Additionally angiomyolipomas are associated with what disease

A

tuberous sclerosis

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8
Q

Describe the pathogenesis of tuberous sclerosis

A

Inhibition of activity of mTOR, kinase that stimulates cells growth TSC1 (Ch. 9, hamartin); TSC2 (Ch. 16, tuberin);

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9
Q

What’s the contents found in angiomyolipoma lesions

A

Thick walled blood cells, adipose tissue, and smooth muscle cells

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10
Q

Oncocytoma arises from What cells in the kidneys

A

intercolated cells of the collecting ducks

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11
Q

Describe the gross characteristics of oncocytoma

A

mahogany brown encapsulated lesions with central scarring

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12
Q

Describe the histologic characteristics of o oncocytoma

A

many mitochondria; granular eosinophilic cytoplasm with uniform around nuclei

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13
Q

What are risk factors for renal cell carcinoma

A

Tobacco use, hypertension, obesity, unopposed estrogen therapy, asbestos, petroleum, and heavy metal exposure

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14
Q

What comorbidities are associated with increased risk for renal cell carcinoma

A

In stage renal disease, DM, cystic kidney disease, and tuberous sclerosis

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15
Q

The most common septype of renal cell carcinoma is clear cell. List the different variants within this subtype

A

Von Hippel-Lindau syndrome; tuberous sclerosis; hereditary papillary carcinoma

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16
Q

What type of inheritance Pattern is associated with all familial forms of renal cell carcinoma

A

Autozone will dominate

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17
Q

Describe the pathogenesis of von Hippel-lindau

A

Overactivation of HIF on VHL gene Located on chromosome 3; promotes angiogenesis, cell growth and some metabolism

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18
Q

List the common clinical manifestations associated with von Hippel-Lindau ccRCC

A

Hemangioblastoma’s of the cerebellum and retina; Pheochromocytoma (adrenal gland tumor)

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19
Q

Describe the pathogenesis of hereditary papillary carcinoma

A

MET Proto oncogene; This gene is involved in many mediated cell processes from growth to differentiation

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20
Q

List the Parineetioplastic syndromes associated with renal cell carcinoma

A

PEAR:
PTH: Hypercalcemia
EPO: polycythemia
ACTH: Cushing syndrome
Renin: hypertension

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21
Q

What is a unique manifestation of perineal plastic syndrome in males

A

left-sided varicocele; Tumor that blocks the left renal vein which drains into the left testicular vein

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22
Q

Clear cell rcc’s originate in what part of the kidney

A

Proximal tubule

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23
Q

Describe the histologic features of clear cell RCC

A

clear cytoplasm; chicken wire pattern of branching basculature; Clear cytoplasm is due to abundance of lipids and glycogen

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24
Q

Carcinomas have a tendency To invade what structure

A

the renal lane; usually unilateral and rarely bilateral

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25
Q

Describe the gross characteristics of CCRCCS

A

cystic Yellow to gray white lesions with extensive hemorrhaging

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26
Q

Describe the different grades of CCR CC

A

1: Small come around, uniform nuclei That looked like lymphocytes
2: slightly irregular nuclei; seen at 40x power
3: Very irregular nuclei; seen at 10x power
4: Mitosis with bizarre multilobulated pleomorphic cells w/ sacromatoids

27
Q

papillary renal carcinoma is commonly seen in which patients

A

Patients with dialysis associated cystic disease

28
Q

Describe the gross characteristics of Papillary rcc

A

Multifocal hemoretic cystic lesions

29
Q

describe the different pathogenesis of capillary rcc

A

Associated with Trisomies of seven, 16, 17, loss of Y chromosome; Note: MET Proto onto gene located on chromosome 7

30
Q

Capillary rcc Originates from what part of the kidneys

A

distal convoluted tubules

31
Q

Describe the histologic characteristics of papillary rcc

A

Foamy macrophages and psammona bondies

32
Q

Describe the histologic characteristics of chromophobe RCC

A

Pill ears and excitoplasm with a vegetable cell wall appearance And often have a halo found around the nucleus

33
Q

Describe the gross characteristics of chromophobic rcc

A

Well circumcised globular solid tan brown lesions

34
Q

chromophobe rcc originates from what cells in the kidneys

A

Intercolated cells

35
Q

Describe the pathogenesis of chromophobe Rcc

A

Multiple chromosome losses

36
Q

Describe the pathogenesis of XP11 translocation rcc

A

Translocations of the TFE 3 gene located at Position xp11.2; Over expression of TFE 3 transcription factor

37
Q

XP11 translocation rcc is commonly found in what population of patients

A

young patients

38
Q

Bellini RCC Originates from what structure in the kidneys

A

Collecting Ducks In the medulla

39
Q

Logic features ofbellini rcc

A

nest malignant cells within fibrotic stroma Along with complex duct like tubular cells

40
Q

How are rcc tumors stage with TNM

A

‘T: Primary tumor
N: regional lymph nodes
M: Distant metastasis

41
Q

Describe the different stages of T and MRCC

A

T1 less than seven centimeters; T2 greater than seven centimeters; T three extends into major veins and perinephrat tissues; T4 extends beyond gerota’s fascia

42
Q

What is the most common primary renal tumor found in pediatric patients

A

nephoroblastoma; aka Wilms tumor

43
Q

Nephroblastoma is associated with what syndromes

A

WAGR syndrome; DD syndrome; BW syndrome

44
Q

Describe the pathogenesis of WAGR syndrome

A

Deletion of 11p13; WT1 gene;

45
Q

List the clinical manifestations of wagr syndrome

A

aniridia, Genital anomalies, intellectual disabilities

46
Q

what is the pathogenesis of DD syndrome

A

mutated WT1 gene

47
Q

List the clinical manifestations of DD syndrome

A

Gonadal dysgenesis; Early onset of Diffuse mesangial sclerosis and renal failure

48
Q

What is the pathogenesis of BW syndrome

A

Deletion of 11p15

49
Q

List the clinical manifestations of WBS

A

organomegaly, Macroglossia, hemi Hypertrophy, omphalocele, enlarged urinals

50
Q

What’s the clinical manifestations found In pediatric patients with Nephroblastoma

A

Large abdominal mass, hematuria, hypertension, intestinal obstruction due to read and release; Occasionally With hepatic pulmonary metastasis

51
Q

describe the gross pathology of nephroblastoma

A

Soft homogeneous mass that is well circumcised with a fibrous pseudocapsule

52
Q

Describe the histologic characteristics of neuroblastoma

A

Stromal component: Fibrocytic or myxoid w/ Skeleton muscle, adipose tissue, Cartilage, bone differentiation; Additionally epithelial structures and blastema Immature mesenchyme) is also present

53
Q

Nephroblastoma with anaplasia is associated with what mutations

A

TP53

54
Q

Describe the characteristics of blastemia`

A

sheets of uniform small blue cells that are densely packed

55
Q

Describe the characteristics of The epithelial structures found a nephroblastoma

A

poorly differentiated tubular structures

56
Q

describe the characteristics of the Stroma component of nephrolasoma

A

fibrovascular with fibroblasts and smooth muscle

57
Q

Transitional cell carcinomas are found in what renal structures

A

The pelvis and callouses To the distal urethra which is covered by transitional epithelium

58
Q

what gene deletion is associated with superficial papillary and non evasive institute lesions of TCC

A

9P deletion

59
Q

invasive tc’s are associated with what gene pathogenesis

A

17P deletions and P503 MUTATIONS

60
Q

What are the risk factors for tcc

A

cigarette spoken, exposure to polycyclic aromatic hydrocarbons, aromatic amines, long term analgetic use, radiation, family history

61
Q

Aggressive TCC invasion into the renal parent kinda leads to what problems

A

Obstruction and dilation of the pelvis and callouses which produces hydro nephrosis

62
Q

describe the histologic characteristics of tcc

A

pleomorphic nuclei in the epithelium; fibrovascular core surrounded by stratified transitional epithelium

63
Q

List the clinical manifestatins of TS.

A

assoc. w/ angiofibromas

Nephrology (11 decks)

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