Renal Neoplastic Disease

Question 1

Where does renal cell carcinoma originate?

Answer 1

renal cortex

Question 2

What is the most common renal neoplasm?

Answer 2

renal cell carcinoma

Question 3

Where is incidence o f renal cell carcinoma the highest?

Answer 3

Czech Republic and North America

Question 4

T/F renal cell carcinoma is 50% more common in men than women

Answer 4

true

Question 5

What is the most common subtype of renal cell carcinoma?

Answer 5

clear cell (75-85%)

Question 6

Where do clear cell and papillary RCC originate?

Answer 6

PCT

Question 7

Where do chromophobe and oncocytoma RCC originate?

Answer 7

cortical collecting duct intercalated cells

Question 8

Where do collecting duct carcinoma originate?

Answer 8

medullary collecting duct

Question 9

What disease are clear cell carcinomas associated with?

Answer 9

von Hippel-Lindau

Question 10

What chromosome mutation is common with papillary carcinoma?

Answer 10

trisomy 7

Question 11

What is the most aggressive type of renal cell carcinoma?

Answer 11

collecting duct carcinoma. affects younger and black patients but is rare

Question 12

What are oncocytomas composed of?

Answer 12

oncocytes which are large differentiated cells with eosinophilic granular cytoplasm

Question 13

Classic triad of renal cell carcinoma

Answer 13

hematuria, flank pain, palpable mass

Question 14

Microscopic appearance of clear cell carcinoma

Answer 14

clear cytoplasm; bland cells form solid nests and fine vasculature

Question 15

Microscopic appearance of papillary carcinoma

Answer 15

delicate vascular cores with overlying tumor cells. Papillary tips may become necrotic (psammoma bodies)

Question 16

Microscopic appearance of chromophobe carcinoma

Answer 16

sheets of pink (eosinophilic) cells with perinuclear halos

Question 17

Why may there be polycythemia or erythrocytosis with renal cell carcinoma?

Answer 17

may increase EPO. Increased levels of EPO may also be seen secondary to hypoxia of the normal renal parenchyma as a result of compression

Question 18

3 major criteria for simple cyst

Answer 18

round and sharply demarcated, No echoes, good transmission through the cyst

Question 19

What is the primary reason to investigate a renal mass?

Answer 19

to exclude a malignant neoplasm

Question 20

Most common metatastic sites for renal cell carcinoma

Answer 20

lung, lymph nodes, bone, liver, and brain.

Question 21

Gold standard therapy for RCC

Answer 21

radical nephrectomy

Question 22

T/F For a tumor <4cm, there is equivalent survival of patients undergoing partial nephrectomy vs radical nephrectomy

Answer 22

true

Question 23

Most common renal malignancy in children

Answer 23

Wilm’s Tumor

Question 24

Clinical features of Wilm’s Tumor

Answer 24

palpable mass***, abdominal pain, hematuria, HTN

Question 25

Chromosome abnormalities associated with renal papillary adenoma (benign renal tumor)

Answer 25

trisomy 7 and 17

Question 26

Define renal fibroma/Hamartoma

Answer 26

Small benign fibrous nodules in renal pyramids

Question 27

Define angimyolipoma

Answer 27

Benign tumor composed of blood vessels (angio), smooth muscle (myo), and adipose tissue (lipoma)

Question 28

What percent of patients with tuberous sclerosis present with angiomyolipoma?

Answer 28

50%