Renal Neoplastic Disease Flashcards
Where does renal cell carcinoma originate?
renal cortex
What is the most common renal neoplasm?
renal cell carcinoma
Where is incidence o f renal cell carcinoma the highest?
Czech Republic and North America
T/F renal cell carcinoma is 50% more common in men than women
true
What is the most common subtype of renal cell carcinoma?
clear cell (75-85%)
Where do clear cell and papillary RCC originate?
PCT
Where do chromophobe and oncocytoma RCC originate?
cortical collecting duct intercalated cells
Where do collecting duct carcinoma originate?
medullary collecting duct
What disease are clear cell carcinomas associated with?
von Hippel-Lindau
What chromosome mutation is common with papillary carcinoma?
trisomy 7
What is the most aggressive type of renal cell carcinoma?
collecting duct carcinoma. affects younger and black patients but is rare
What are oncocytomas composed of?
oncocytes which are large differentiated cells with eosinophilic granular cytoplasm
Classic triad of renal cell carcinoma
hematuria, flank pain, palpable mass
Microscopic appearance of clear cell carcinoma
clear cytoplasm; bland cells form solid nests and fine vasculature
Microscopic appearance of papillary carcinoma
delicate vascular cores with overlying tumor cells. Papillary tips may become necrotic (psammoma bodies)
Microscopic appearance of chromophobe carcinoma
sheets of pink (eosinophilic) cells with perinuclear halos
Why may there be polycythemia or erythrocytosis with renal cell carcinoma?
may increase EPO. Increased levels of EPO may also be seen secondary to hypoxia of the normal renal parenchyma as a result of compression
3 major criteria for simple cyst
round and sharply demarcated, No echoes, good transmission through the cyst
What is the primary reason to investigate a renal mass?
to exclude a malignant neoplasm
Most common metatastic sites for renal cell carcinoma
lung, lymph nodes, bone, liver, and brain.
Gold standard therapy for RCC
radical nephrectomy
T/F For a tumor <4cm, there is equivalent survival of patients undergoing partial nephrectomy vs radical nephrectomy
true
Most common renal malignancy in children
Wilm’s Tumor
Clinical features of Wilm’s Tumor
palpable mass***, abdominal pain, hematuria, HTN
Chromosome abnormalities associated with renal papillary adenoma (benign renal tumor)
trisomy 7 and 17
Define renal fibroma/Hamartoma
Small benign fibrous nodules in renal pyramids
Define angimyolipoma
Benign tumor composed of blood vessels (angio), smooth muscle (myo), and adipose tissue (lipoma)
What percent of patients with tuberous sclerosis present with angiomyolipoma?
50%
