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Renal > Renal Neoplasms > Flashcards

Renal Neoplasms Flashcards

1
Q

What is the most common neoplasm in adults?

A

Clear Cell Carcinoma (70%)

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2
Q

What is an angiomyolipoma?

A

A benign mesenchymal tumour composed of adipose, smooth muscle, and thick-walled blood vessels

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3
Q

What is angiomyolipoma most often seen with?

A

Patients with tuberous sclerosis

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4
Q

What is an oncocytoma?

A

A benign renal epithelial neoplasm composed of large cells with mitochondria-rich eosinophilic cytoplasm

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5
Q

What is the key feature of oncocytoma?

A

Mitochondria making granular tissue

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6
Q

What “color” and “pattern” is associated with oncocytoma?

A

Mahogany brown and a central stellate scar

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7
Q

Can an oncocytoma be multiple?

A

Yup

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8
Q

Are there a lot of mitotic figures in oncocytoma? And what will be seen in an electron microscope?

A

Not a lot mitotic w/ granular tissue, you’ll see mitochondria

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9
Q

What are the main sites of metastasis for renal carcinoma?

A

Lung, Bone, Brain, and Skin

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10
Q

What are the methods of spread of renal cell carcinoma?

A

Direct, Hematogenous (Metastasis), Contiguous venous spread, lymphatic, urine

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11
Q

What is meant by direct spread?

A

Through the capsule into the perinephric fat, to the renal pelvis, through gerota’s fascia, or rarely to adjacent organs

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12
Q

What lymph nodes will renal cell carcinoma spread to?

A

Renal hilar, Para-aortic, and rarely cervical nodes

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13
Q

What is the common question stem for renal cell carcinoma?

A

A 54 year old man with dull flank pain and painless hematuria….

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14
Q

Is the enlarging mass usually encapsulated?

A

Yes

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15
Q

Are necrosis and hemorrhage common?

A

Yes

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16
Q

What kind of tumor is easily palpated?

A

Wilm’s tumor (lol, larry), and huge ones

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17
Q

What is clear cell carcinoma?

A

The most common, it is a malignant neoplasm composed of cels with clear or eosinophilic cytoplasm within a delicate vascular network

18
Q

Can clear cell carcinoma show color?

A

Yes, yellow due to lipids. Red due to hemorrhage, Black due to necrosis

19
Q

Is clear cell carcinoma polar and solitary?

A

Yes, usually, often with cysts too

20
Q

The vast majority of CCC express abnormality on?

A

Chromosome 3p, sporadic or VHL

21
Q

What is the most important prognostic feature?

A

Clinical Stage, then nuclear grade (Fuhrman)

22
Q

True or False. Handorf describes the cells in CCC as empty with small, bland, nuclei.

A

True

23
Q

Sensitivity to what is lose with loss of VHL?

A

Hypoxia

24
Q

What translocations are possible in sporadic CCC?

A

t(3;6), t(3;8), t(3;11) or deletion 3

25
Q

Loss of VHL, inactivated or mutated VHL, or hypermethylation of VHL result in what type of CCC?

A

Hereditary CCC

26
Q

What is papillary carcinoma?

A

Malignant renal parenchymal tumor with a papillary or tubulopapillary architecture

27
Q

Bilateral and multifocal tumors are (more/less) common than with other renal malignancies?

A

More

28
Q

Although there is no standard cytogenetic characteristic, what is common with the hereditary variant?

A

7q

29
Q

Acquired dialysis related renal cystic disease results in a (30/40/50/60) fold increase in renal cancer. Of that (60/50/40/30) is CCC and (60/50/40/30) is papillary.

A

50, 60, 40

30
Q

Does furhman apply to papillary carcinoma?

A

Nope

31
Q

In both sporadic and hereditary papillary carcinoma what is mutated and activated?

A

MET

32
Q

What trisomy will be in hereditary and what trisomies will be in sporadic?

A

7 in hereditary, 7, 16, 17 may be in sporadic (as well as loss of Y, or t(X;1) -> PRCC oncogenes

33
Q

What is Chromophobe carcinoma?

A

Large pale cells with prominent cell membranes, no genetic signature, low mortality

34
Q

What stain is chromophobe carcinoma positive for but we wont be tested on?

A

Hale’s colloidal iron

35
Q

What percentage of people who smoke will have some type of renal pelvis carcinoma?

A

100%

36
Q

What is the most common pediatric neoplasm and what is it’s incidence in the US?

A

WIlm’s Tumor/Nephroblastoma and about 400-600 cases per year. Rare in adults

37
Q

Peak incidence for wilm’s is seen when?

A

2nd-5th year of life (95% of kidney cancer in children)

38
Q

Post therapy of wilms has 5 yr survival is 90%, but what is it without therapy?

A

0%

39
Q

What is wilms a mixture of?

A

Cellular elements (blastemal, stromal, epithelial)

40
Q

What is wilms a mixture of?

A

Cellular elements (blastemal, stromal, epithelial)

Renal (33 decks)

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