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CPR II Block 2 > Renal Pathology > Flashcards

Renal Pathology Flashcards

1
Q 
Nephrotic Syndrome
Major Characteristics (4)
A

Proteinuria (>3.5 g/day)
Hypoalbuminemia (Plasma < 3 g/dL)
Generalized Edema
Compensatory Hyperlipidemia

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2
Q 
Nephritic Syndrome
Major Characteristics (3)
A

Hematuria
HTN
Azotemia

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3
Q

In Situ Immune Complex Formation

Mechanisms with Microscopy (2) and Examples (4)

A

Abs to intrinsic tissue antigens
Linear immunofluorescence
Goodpasture syndrome

Abs to extrinsic antigens planted in glomerulus
   Granular immunofluorescence
Postinfectious Glomerulonephritis
Membranous nephropathy
Membranoproliferative Glomerulonephritis
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4
Q

Circulating Complex Deposition

Examples (4)

A

Systemic Lupus Erythematosus
IgA Mediated Nephropathy
HBV/HCV Infections
Allergens

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5
Q

Acute Proliferative Glomerulonephritis

Pathogenesis, Morphology (4), Causes (3)

A

Immune complex mediated damage most often from deposition of postinfectious antigens

Hypercellularity
Leukocyte Infiltration
IgG/IgM/C3 granular deposits
Subepithelial humps

M protein Streptococcus (kids)
Post-staphylococcus
Some viruses and parasites

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6
Q

Acute Proliferative Glomerulonephritis Presentations

Kids (5) and Adults (4)

A 
Age 6-10
Post strep pharyngitis/impetigo*
Nephritic syndrome
Dysmorphic RBCs
Periorbital edema
Aggressive and atypical*
Sudden HTN
Edema
Increased BUN
Only 60% fully recover
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7
Q

RPGN Type I

Etiology (2), HLA Association, Treatment

A

Anti-Basement Membrane Abs
Abs to Type IV collagen (Goodpasture)

HLA-DRB1

Plasmapharesis and immunosuppression

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8
Q

Rapidly Progressive Glomerulonephritis

Morphology (4) and Presentation (3)

A

Basement membrane tears (wrinkling)
Crescentic lesions of proliferating epithelial cells
Collapsed glomerular tufts
Macrophage/Leukocyte infiltrates

Rapid progressive renal function loss
Severe oliguria
Nephritic syndrome

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9
Q

RPGN Type II

Cause, Microscopy and Treatment

A

Immune complex deposition (SLE, IgA, APG)

Subendothelial Granular immunofluorescence

Treat the underlying condition

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10
Q

RPGN Type III

Diagnosis and Examples (2)

A

Cirulating ANCA proteins

Granulomatosis with polyangiitis (PR3 ANCA)
Microscopic Polyangiitis (MPO ANCA)
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11
Q

Nephrotic Syndrome Causes

Primary (3) and Secondary (5)

A

Membranous Nephropathy
Minimal Change Disease
Focal Segmental Glomerulosclerosis

Diabetes
Amyloidosis
SLE
Drugs (NSAIDS, Heroin)
Malignancy
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12
Q

Membranous Nephropathy

Pathogenesis (3), Morphology (2) and Presentation (3)

A

Diffuse thickening of glomerular capillary wall
From HLA-DQA1 mutation and PLA2 receptor Abs

Subepithelial IgG4 deposits
Spike formations

Nephrotic syndrome
Non-selective proteinuria
Hematuria

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13
Q

Minimal Change Disease

Microscopy, Clinical Features (3), Treatment, Association

A

Foot Process Effacement
Only visible on Electron Microscopy

Most common Primary NS in children
Selective proteinuria
Edema

Very responsive to corticosteroids

Secondary to Non-Hodgkin Lymphoma (adults)

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14
Q

Focal Segmental Glomerulosclerosis Causes

Primary (1) and Secondary (3)

A

Primary
Idiopathic: Most common cause of NS in US**

Secondary (glomerular injury)
HIV Associated: collapsing variant possible
Ablation Nephropathy: loss of renal tissue
Genetic Mutation: NPHS, TRPC6, alpha-Actinin

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15
Q

Focal Segmental Glomerulosclerosis

Morphology (3), Clinical Features (6), Microscopy (2)

A

Foot Process Effacement (electron microscopy)
Sclerosis
Collapsing Glomerulopathy

Mixed Nephrotic/Nephritic: 
Hematuria
Nonselective proteinuria
Decreased GFR
HTN
Progresses to CKD

Focal IgM and C3 immunofluorescence
Focal Segmental Sclerosis (light microscopy)

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16
Q

Type I Membranoproliferative Glomerulonephritis

Pathogenesis (3), Presentation (2) and Microscopy (3)

A

Immune complexes in glomerulus
Activation of classic and alternative complement paths

Mixed GD: hematuria and proteinuria

Mesangial proliferation (Light)
Subendothelial deposits (Electron)
IgG, C3, C1q, C4 granular immunofluorescence
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17
Q

Type I MPGN Primary vs Secondary

Age, Prognosis, Associations (2)

A 
Primary
Presents younger
Nephrotic/Nephritic
HTN
50% progress to chronic
Secondary
Presents in adults
Associated with Chronic Antigenemia
Seen in Hep C/SLE/Cancer patients
50% progress to chronic
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18
Q

Type II Membranoproliferative Glomerulonephritis

Pathogenesis (2), Presentation (4) and Microscopy (4)

A

C3 Nephritic Factor binds C3 convertase
C3C activates alternative complement pathway

Hematuria
Nephritic Syndrome
Progression to CKD (poorer prognosis)
Primary disease in kids/young adults

Mesangial proliferation (LM)
GBM splitting (LM)
C3 and IgG deposits (IF)
Dense deposits (EM)
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19
Q 
IgA Nephropathy
Clinical Features (5), Microscopy (1)
A

Recurrent Hematuria after mucosal infections**
Most common cause of glomerulonephritis
More common in young adults, whites/asians, males
Familial component
Associated with gluten enteropathy

IgA in mesangium (IF)**

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20
Q

Chronic Glomerulonephritis

Description (3), Causes (5), Pathologic Features (3)

A

End stage glomerular disease
From either Acute or Asymptomatic Glomerulonephritis
Resulting in Uremia

Crescentic GN**
FSGS
MPGN
Membranous nephropathy
IgA nephropathy

Thinned cortex
Collagenous replacement of Glomeruli
Arterial sclerosis

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21
Q 
Alport Syndrome
Pathologic Features (4), Inheritance (2), Presentation (5)
A

Irregular thickening/thinning of GBM
Lamina densa lamination
Moth eaten or frayed lamina densa appearance
Mutations in Type IV collagen alpha-molecules

X-Linked: males most affected
Autosomal: males/females equally affected

Hematuria
RBC casts
Proteinuria
Neural deafness
Vision disturbances
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22
Q

Thin Basement Membrane Disease

Clinical Feature, Inheritance (2), Pathologic Feature

A

Familial asymptomatic hematuria**

Most people heterozygous carriers
Homozygous see defective Type IV collagen

Diffuse thinning of GBM

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23
Q

Secondary Nephrotic Syndrome Causes (4)

A

Diabetic Nephropathy
SLE (mixed)
Hepatitis C (MPGN Type I)
HIV Nephropathy (FSGS)

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24
Q

Secondary Nephritic Syndrome Causes (4)

A

SLE (mixed)
Bacterial Endocarditis (Acute Proliferative)
Goodpasture Syndrome (RPGN)
Henoch-Shonlein Purpura (IgA Nephropathy)

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25
Q

Diabetic Mellitus

Epidemiology (2) and Common Complications (4)

A

Leading cause of end stage renal failure in US (30%)**
Happens in 40% of diabetics

Nephropathy
Retinopathy
Cataracts
Neuropathy

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26
Q

Diabetic Nephropathy Morphologic Changes

Glomerulus (4), Papilla (2), Vasculature

A

Thickened GBM
Diffuse mesangial sclerosis
Nodular glomerulosclerosis
Via hyperglycemia and hypertrophy

Necrotizing papillitis (via pyelonephritis)

Arteriolosclerosis

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27
Q

Lupus Nephritis

Pathogenesis and Spectrum (I-VI)

A

Subendothelial immune complex deposits disrupt glomerulus

Minimal mesangial lupus nephritis (class I)
Focal lupus nephritis (class II)
Mesangial proliferative lupus nephritis (class III)
Diffuse lupus nephritis (class IV)
Membranous lupus nephritis (class V)
Advanced sclerosing lupus nephritis (class VI)
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28
Q

Henoch-Schönlein Purpura

Description, Presentation (5), Morphology (2)

A

IgA nephropathy associated with systemic vaculitis

Purpuric skin lesions**
Abdominal pain
Intestinal bleeding
Arthralgias
Recurrent Hematuria**
IgA, IgG and C3 deposition in mesangium (IF)
Mesangial proliferation (LM)
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29
Q

Bacterial Endocarditis Glomerulonephritis

Presentation (2) and Microscopy

A

Hematuria
Proteinuria

Glomerular immune complex deposits

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30
Q

Fibrillary Glomerulonephritis

Presentation (3) and Morphology (2)

A

Nephrotic syndrome
Hematuria
Progressive renal insufficiency

Fibrillar deposits in mesangium and glomerular capillaries

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31
Q

Common Histology of Goodpasture, Granulomatosis with Polyangiitis and Microscopic Polyangiitis (2)

A

Crescent Lesions

Foci of Glomerular Necrosis

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32
Q

Acute Tubular Injury

Etiology (2), Pathology (4), Histology (2)

A

Ischemia
Endogenous/Exogenous Toxic Agents

Tubule cell injury leading to:
Tubuloglomerular feedback
Tubule obstruction (by casts)
Tubular back leak

Focal Tubular epithelial necrosis
Swollen epithelial cells with vacuolization

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33
Q

Acute Tubular Injury Clinical Phase Descriptions

Initiation (1), Maintenance (2), Recovery (3)

A

Initiation: Oliguria

Maintenance: Uremia, Hyperkalemia*

Recovery: Polyuria, Hypokalemia*, Infection susceptibility

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34
Q

Tubulointerstitial Nephritis
Presentation (2), Etiologies (5)
and Features of Acute (3) vs Chronic (2)

A

Azotemia**
Inability to concentrate urine

Infections, Toxins, Metabolic Diseases, Obstruction, Neoplasms

Acute shows edema, eosinophils and neutrophils
Chronic shows fibrosis and tubular atrophy

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35
Q 
Acute Pyelonephritis
Predisposing Factors (4), Etiologies (5), Morphology (4)
A

Vesicoureteral reflux**
Diabetes
Pregnancy
Males with BPH

Ascending Cystitis from gram negative bacteria
(E. coli, Klebsiella, Proteus, Enterobacter)

Patchy interstitial inflammation
Intratubular neutrophils
Tubulitis
Tubular necrosis

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36
Q

Pyelonephritis Complications (3)

A

Papillary necrosis
Pyonephrosis
Perinephric abscess

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37
Q

Chronic Pyelonephritis

Definition (3), Etiologies (3) and Morphology (3)

A

Chronic tubulointerstitial inflammation leading to scarring of calyces and pelvis

**Analgesic nephropathy: Vesicoureteral reflux with superimposed UTI
Chronic Obstructive Pyelonephritis: BPH
Xanthogranulomatous: Proteus infections

Polar scarring
Dilated, blunted or deformed calyces
Flattened papillae

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38
Q

Papillary Necrosis Etiologies (3)

Ratios, Time course, Infection and Calcification

A

Diabetes Mellitus
Mostly female, 10 years, Infectious, no calcification

Analgesic Nephropathy
Mostly female, 7 years, Non-Infectious, calcification

Obstruction
Mostly male, variable time, Infectious, Calcification

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39
Q

Myeloma Kidney

Etiology (2), Morphology (3) and Clinical Features (2)

A

Bence-Jones proteinuria and cast nephropathy

Pink/Blue masses distending tubular lumens
Interstitial inflammation and fibrosis

Insidious chronic kidney disease
Proteinuria

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40
Q

Nephrolithiasis

Epidemiology (2), Predisposing Factors (4), Minerals (4)

A

Usually unilateral
Most often in men aged 20-30**

Increased mineral concentration**
pH disturbances
Decreased urine volume
Bacteria

Mostly Calcium**
Also Magnesium, Uric acid, and cystine

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41
Q

Benign Nephrosclerosis

Definition, Etiologies (3) and Morphology (3)

A

General process of hyaline sclerosis of renal arterioles and small arteries (not a diagnosis)

Increasing age
HTN
Diabetes mellitus

Cortical scarring and shrinking
Hyaline arteriolosclerosis
Patchy ischemic atrophy

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42
Q

Malignant Hypertension

Pathogenesis (5) and Definition

A

Renal vascular damage causes endothelial injury
Vascular cell death causes focal hemorrhage
Platelets form thrombus, leads to ischemia
Fibrinoid necrosis causes hyperplastic arteriolitis
Decreased renal perfusion causes continuous RAAS

BP over 180/120

43
Q

Malignant Nephrosclerosis

Morphology (3) and Presentation (5)

A

“Flea bitten” petechial hemorrhage
Arteriolar fibrinoid necrosis
Interlobular hyperplastic arteriolitis

Early on increased intracranial pressure
Retinal hemorrhage
Papilledema
Encephalopathy (emergency)
Renal failure
44
Q

Renal Artery Stenosis

Etiologies (2), Complications (2) and Treatment

A

Renal A atheromatous occlusion
Fibromuscular dysplasia

HTN (similar to essential)
Shrunken kidney

Surgical stenting

45
Q

Thrombotic Microangiopathies Descriptions

Typical, Atypical (2) and TTP (2)

A

Typical Hemolytic-Uremic Syndrome:
Diarrhea from Shiga Toxin exposure

Atypical Hemolytic-Uremic Syndrome:
Inherited mutations in Complement Regulators*
Acquired endothelial injuries

Thrombotic Thrombocytopenic Purpura:
Inherited ADAMTS13 deficiency (von willebrand)
Neurologic Symptoms

46
Q 
Thrombotic Microangiopathies 
Common Pathology (2) and Morphology (4)
A

Endothelial damage and activation
Excessive platelet activation and aggregation

Cortical necrosis
Thrombotic glomerular capillary occlusion
Mesangiolysis
Interlobular arteriolar fibrinoid necrosis

47
Q

Atheroembolic Renal Disease

Morphology (4) and Risk Factors (3)

A

Atrophy
Fibrosis
Hemorrhage
Necrosis

Atherosclerosis
AAA repair
Intra-aortic cannulization

48
Q

Renal Infarcts

Pathogenesis, Compounding Risks (2)

A

Embolism mostly from mural thrombi from left heart

End organ blood supply
Lack of collateral circulation

49
Q

Diffuse Cortical Sclerosis

Etiologies (2) Complications (2) and Morphology (2)

A

Obstetric surgery or Septic shock

Causes systemic hypoperfusion and hypoxia

Coagulative necrosis of renal glomeruli and tubules

50
Q

Major Renal Congenital Anomalies (4)

A

Kidney Agenesis (rare)
Unilateral shows hypertrophy and hypertension
Bilateral is death

Kidney Hypoplasia
Usually unilateral, shows low birth weight

Ectopic Kidney
Kidneys in pelvis, increases bacterial UTIs

Horseshoe Kidney (common)
Usually fusion of lower poles, sits across midline vessels
51
Q

Autosomal Dominant Polycystic Kidney Disease

Mutations (2), Pathologic Features (4), Presentation (6) and Prognosis

A

PKD1 or PKD2 mutations
PKD1 is more common

Always bilateral
Mitral valve prolapse
Liver cysts
Berry aneurysms*

Presents in Adults*
Hematuria
Flank pain
UTIs
Nephrolithiasis
HTN

Chronic renal failure by age 40-60
(PKD2 better prognosis)

52
Q

Autosomal Recessive Polycystic Kidney Disease

Mutation, Pathologic Features (2) and Prognosis

A

PKHD1 gene defect

Enlarged cystic kidneys at birth
Hepatic fibrosis

Death in infancy/childhood

53
Q

Medullary Sponge Kidney

Pathologic Feature, Presentation (3) and Prognosis

A

Medullary cysts

Hematuria
UTIs
Recurrent nephrolithiasis

Benign

54
Q

Familial juvenile Nephronophthisis

Inheritance, Pathologic Features (2), Presentation (4) and Prognosis

A

Autosomal recessive

Corticomedullary cysts
Shrunken kidneys

Salt wasting
Polyuria
Growth retardation
Anemia

Progressive renal failure in childhood

55
Q

Adult Medullary Cystic Disease

Inheritance, Pathologic Features (2), Presentation (2) and Prognosis

A

Autosomal dominant

Corticomedullary cysts
Shrunken kidneys

Salt wasting
Polyuria

Progressive renal failure in adulthood

56
Q 
Multicystic Renal Dysplasia
Pathologic Features (3) and Prognosis (2)
A

Variable kidney cysts
Ureter agenesis
Ureteropelvic obstruction

Renal failure if bilateral
Surgically curable if unilateral

57
Q 
Dialysis Associated Cystic Disease
Pathologic Features (2), Presentation (3)
A

Numerous cortical and medullary cysts

Hemorrhage
Erythrocytosis
Renal cell carcinoma

58
Q 
Simple Renal Cysts
Pathologic Features (2), Presentation
A

Normal sized kidneys
Cortical cyst with clear fluid

Microscopic hematuria

59
Q

Urinary Tract Obstruction

Main Complication and Clinical Presentations (4)

A

Hydronephrosis: Dilated renal pelvis/calyces and progressive renal atrophy

Acute: Pain/Bladder issues from underlying cause
Unilateral complete: silent, diagnosed with ultrasound
Bilateral Partial: Polyuria, Nocturia and HTN
Bilateral Complete: Anuria, Postobstructive diuresis

60
Q

Renal Papillary Adenoma

Classification, Cytogenetics (2) and Morphology (3)

A

Benign if < 1cm
Most common benign renal neoplasm

Trisomies 7 and 17

Appear cortical, discrete and yellow-gray

61
Q 
Renal Oncocytoma
Gross Appearance (4), Origin and Histology
A

Mahogany brown
Well circumscribed
Central stellate scar
Large: 10-15 cm**

Type A Intercalated Cells

Eosinophilic cells with numerous mitochondria

62
Q

Renal Angiomyolipoma

Association, Complication and Morphology (3)

A

Loss of TSC1/TSC2 tumor suppressor genes
(Tuberous Sclerosis)

Hypovolemic shock via spontaneous hemorrhage

Thick walled vessels
Smooth muscle proliferation
Fat cells

63
Q

Familial Renal Cancer Syndromes

Examples (4) and Clinical Relevancy

A

Von Hippel-Lindau: Hereditary and sporadic clear cell renal carcinomas

Hereditary Leiomyomatosis: aggressive papillary carcinoma

Hereditary Papillary Carcinoma: MET oncogene causes Sporadic and Hereditary Papillary carcinoma

Birt-Hogg-Dube: see skin, pulmonary and renal tumors

64
Q

Renal Cell Carcinoma Cytogenetic/Genetic Factors

Papillary (2) and Familial (1)

A

Papillary associated with Trisomy 7
Papillary associated with mutated activated MET

Familial Clear cell have Chr 3 VHL translocation/deletion

65
Q 
Renal Cell Carcinoma Morphology 
Clear cell (2), Papillary (2), Chromophobe (2)
A

Clear cell: non-papillary growth and clear cytoplasm

Papillary: papillary growth and multifocal

Chromophobe: pale eosinophilic cytoplasm with nuclear halos

66
Q

Renal Cell Carcinoma

Presentation (3), Prognoses (4) and Main Danger

A

Hematuria
Costovertebral pain
Palpable flank mass

Chromophobe is best
Papillary and Clear cell are moderate
Collecting Duct/Sarcomatoid/Medullary are worst

Hematogenous metastasis while remaining subclinical

67
Q

Urothelial (Transitional cell) Carcinoma

Presentation (3) Complications (2)

A

Hematuria
Hydronephrosis
Flank pain

Tubulointerstitial nephropathy
Infiltration of renal pelvis/calyx (poor prognosis)

68
Q

Metastatic Disease to the Kidney

Causes (5) and Description (2)

A

Metastasis of:
Melanoma or Lung, Breast, GI, Pancreas cancers

Multifocal and bilateral

69
Q 
Neuroblastoma
Unfavorable Factors (5)
A 
Stage 3 or 4
Older than 18 months
Poor differentiation
Near diploid
NMYC amplification
70
Q

Wilms Tumor

Precursor, Prognostic Factors (6), Genetic Link

A

Nephrogenic rests are precursor lesion

Favorable: Blastemal, stromal and epithelial cells all present, older age

Unfavorable: Diffuse anaplasia, p53 mutation

WT1 mutation

71
Q

Ureter Congenital Anomalies (3)

A

Double and Bifid Ureters
Ureteropelvic Junction obstruction
Diverticula

72
Q

Ureter Inflammatory Conditions (2)

A

Ureteritis Follicularis

Ureteritis Cystica

73
Q

Ureteral Obstruction Extrinsic Causes (4)

A

Pregnancy
Periureteral inflammation
Endometriosis

Sclerosing Retroperitoneal Fibrosis (IgG4 related)

74
Q

Urinary Bladder

Congenital Anomalies with Complications (4)

A

Diverticulae: bladder infections/calculi

Exstrophy: Adenocarcinoma

Vesicureteral reflux: congenital vesicoureteral fistula

Urachal cysts: Adenocarcinoma

75
Q

Bladder Cystitis - Acute and Chronic

Presentation (4) and Morphologic Types (3)

A

Frequency of urination
Lower abdominal pain
Dysuria (burning)
Low grade fever

Hemorrhagic
Follicular
Eosinophilic

76
Q

Bladder Cystitis

Etiologies (4) and Predisposing Factors (5)

A

E. coli
Klebsiella
Proteus
Enterobacter

Calculi
Obstruction
Diabetes
Immune Deficiency
Radiation
77
Q 
Interstitial Cystitis
Pathologic Features (3) and Presentation (3)
A

Glomerulations
Hunner’s Ulcer
Mast cells

Intermittent severe suprapubic pain
Presents in females 30-40

78
Q 
Malacoplakia
Cause Morphology (2) and Population
A

Defective phagosomes causing chronic E coli infection
Inflammation and plaque formation
Granular macrophages with Michaelis Gutmann bodies

Presents in middle aged women

79
Q

Polypoid cystitis

Cause and Misdiagnosis

A

Indwelling catheters

Papillary carcinoma

80
Q

Nephrogenic Adenoma

Pathology (2)

A

Renal tubular cells implanted in urothelium

Urothelium replaced with cuboidal epithelium

81
Q

Cystitis Cystica/Glandularis

Pathogenesis (3) and Population

A

Nests of Brunn form
Metaplasia into cuboidal/columnar (glandularis)
Urothelium retracts and flattens (cystica)

Mostly male

82
Q

Papillary Urothelial Carcinoma

Stages (5)

A 
Exophytic papilloma
Inverted papilloma
Carcinoma in situ
PUNLMP (thickened epithelium)
Low/High Grade Papillary Urothelial cancers
83
Q

Urothelial Carcinoma

Presentation (2), Risk Factors (4), Morphology (2)

A

Painless hematuria
Presents in people over 65 years

Smoking
Cyclophosphamide
Phenacetin
p53 mutation

Hyperchromatic cells
Huge nuclei

84
Q

Mesenchymal Bladder Tumors

Adult vs Pediatric

A

Leiomyomas in adults
(intramural, encapsulated)

Embryonal Rhabdomyosarcoma in kids
(Grape-like mass)

85
Q 
Urethritis - Gonococcal and Non-Gonococcal
Main Causes (2) and Male/Female Difference
A

Gonorrhea
Chlamydia

Males are symptomatic and females are not

86
Q

Reactive Arthritis

Presentation (3) and Description

A

Arthritis
Conjunctivitis
Urethritis

Non-infectious inflammatory urethritis

87
Q

Primary Carcinoma of the Urethra

Commonness and Proximal/Distal Differences

A

Not common

Proximal: urothelial differentiation
Distal: Squamous cell carcinoma

88
Q

Epispadias and Hypospadias

Description (3) and Complication

A

Malformation of urethral groove and canal
Ventral if hypospadias
Dorsal if epispadias

Sterility

89
Q

Phimosis

Description and Complications (2)

A

Narrowing of the orifice of the prepuce

Increased risk of infections and carcinoma

90
Q

Balanoposthitis

Description, Causes (2), Complication

A

Infection of the glans and prepuce

Candida albicans
Gardnerella

Smegma

91
Q

Benign Penile Tumor (Condyloma Acuminatum)

Cause and Morphology (3)

A

HPV

Sessile or pedunculated red papillary excrescences
Acanthosis
Koilocytosis

92
Q

Malignant Penile Tumors

CIS (2) and Squamous Carcinoma (2) Associations

A 
Carcinoma in Situ:
Bowen Disease (over 35, solitary lesion)
Bowenoid Papulosis (younger, multiple lesions)

Squamous Carcinoma: HPV associated
Verrucous carcinoma is a subtype

93
Q

HPV Complications

Common Morphology and Examples with HPV Type (4)

A

Koilocytosis

Condyloma Acumunatum (6/11)
Squamous Penile Carcinoma (16/18)
Bowen Disease (16)
Bowenoid Papulosis (16)
94
Q

Cryptorchidism

Description, Histology (2), Timeline (3), Complications (2)

A

Intra-abdominal testis undescended into scrotal sac

Arrested germ cell development
Hyalinization and thickening of Spermatic Tubule BM

Most will spontaneously descend in first year
Orchiopexy required if not descended by two years
After two years histological deterioration happens

Infertility
Testicular Cancer

95
Q

Testis/Epididymis Pathologic Issues (4) with Causes

A

Atrophy: Mostly from Klinefelter

Inflammation: Msotly from UTIs

Autoimmune: idiopathic granulomatous orchitis

Specific Infections: Gonorrhea, Mumps, TB, Syphilis

96
Q

Testicular Torsion - Adult and Neonatal

Causes (2) and Intervention

A

Adult caused by bell-clapper abnormality
Neonatal lacks anatomic defect

Orchiopexy

97
Q

Testicular Germ Cell Tumors

Associated Syndrome, Genetics (2) and Precursor Lesion

A

**Most common tumor in males 15-34

Testicular Dysgenesis Syndrome

KIT and BAK mutations

Intratubular Germ Cell Neoplasia

98
Q

Seminomatous Germ Cell Tumor

Morphology (5)

A

**Most common germ cell tumor

Large, 
Round/polyhedral, 
Distinct cell membrane, 
Clear cytoplasm, 
Central nucleus with nucleoli
99
Q

Non-Seminomatous Germ Cell Tumors

Examples (4)

A

Embryonal carcinoma
Yolk sac tumor (Schiller duval bodies)
Choriocarcinoma
Teratoma (malignant post puberty)

100
Q

Tunica Vaginalis Lesions (5)

A 
Hydrocele
Hematocele
Chylocele
Spermatocele
Varicocele
101
Q

Prostate Inflammation Types (4)

A

Acute Bacterial Prostatitis
Chronic Bacterial Prostatitis
Granulomatous Prostatitis
Chronic Abacterial Prostatitis (most common)

102
Q

Benign Prostatic Hyperplasia

Age, Pathogenesis (2), Initial Location

A

Most common over 50 years

Nodular hyperplasia of stromal and epithelial cells
Influenced by DHT related growth factors

Hyperplasia starts in the transition zone

103
Q

Prostate Adenocarcinoma

Incidence (2), Androgens Role, Genetics (2)

A

Most common form of cancer in men
More common in African Americans

Androgens help cancer grow and survive
(Treat with castration or anti-androgens)

ERG/ETV1 transposed next to TMPRSS2 gene
BRCA2 mutations

104
Q

Prostate Adenocarcinoma Diagnosis

Gleason Score, Biomarkers (2)

A

Low score = more differentiated (better prognosis)
*10 is the highest score with worst prognosis

Prostate specific antigen (PSA)
PCA3

CPR II Block 2 (5 decks)

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