Renal Tumors

Question 1

Size of adenomas for it to be considered malignant potential

Answer 1

More than 3cm

Question 2

Benign tumors found through manifestation and not by accident

Answer 2

Oncocytoma
Renal papillary. Adenoma
Angiomyolipoma

Question 3

Malignant tumors

Answer 3

Renal cell ca - Adenocarcinoma
Wilma tumor
Urothelilal tumor (transitional cell tumor ) of calices and pelvis

Question 4

Cells with renal cell ca

Answer 4

Renal tubular epithelium

Question 5

People affected by renal cell ca

Answer 5

Adult 90%

Question 6

More male or female in renal cell ca

Answer 6

Male 3:1

Question 7

Risk factors renal cell ca

Answer 7

Smoking
Von hipped Lindau syndrome
Acquired cystic disease in long term dialysis
ADPKD

Question 8

Clinical manifestation renal cell ca

Answer 8

Hematuria 
Abdominal mass
Loin pain 
Fever
Weight loss
PUO
Anemia 
High renin 
High ca 
Bone metastasis 
Paranoeplastic syndrome 
Parathormone 
Vit d like substances 
Cushing syndrome 
Glucagon 
Polycythemia 
Gonadotrophine 
Gynecomastia

Question 9

Macro renal cell ca

Answer 9

Spherical lobulated expansile masss
Infiltrating growth 
Compresses kidneys 
Hemorrhagic surface 
Necrosis 
Cyst 
May get into renal vein

Question 10

Micro type of renal cell ca

Answer 10

Clear cell non papillary ca

Papillary ca

Question 11

Clear cell non papillary ca renal cell ca characteristics

Answer 11

70-80%
Clear cells due to lipid and glycogen or Granular cell mitochondria
Ch3p deletion VHL

Question 12

Papillary ca in renal cell ca characteristics

Answer 12

No ch3p deletion

Trisomies 7, 16, 17, loss of y

Question 13

Micro chromophobe renal carcinoma or renal oncocytoma

Answer 13

Well differentiated RCC
Packets of large pale eosinophils
Halo around nucleus

Question 14

Prognosis of chromophobe renal carcinoma

Answer 14

Good

Question 15

Treatment chromophobe renal ca

Answer 15

Néphrectomy

Question 16

5 year survival chromophobe renal ca

Answer 16

4570%

Question 17

What is Wilms tumor nephroblastoma

Answer 17

Embryonic tumor from metanephric mesenchyme

Question 18

Peak age of Wilms tumor

Answer 18

2 to 4 years old

Question 19

Gene Involved in Wilms tumor

Answer 19

WT-1 GENE on chromosome 11

Question 20

Syndrome associated with Wilms tumor inheritance

Answer 20

WAGR syndrome - Wilms tumor, Aniridia, Genital abnormalities ,and Retardation syndrome
Beckwith-wiedemann Hemihypertrophy

Question 21

Clinical manifestation of will tumor

Answer 21

Abdominal mass 
pain 
anorexia
 weight loss
 constipation 
metastatic disease 
fever 
hematuria 
hypertension

Question 22

Will tumor is more unilateral or bilateral

Answer 22

Unilateral 90%

Question 23

Wilms tumor is more on the right or the left kidney

Answer 23

Left kidney

Question 24

MacroMorphology of Wilms tumor

Answer 24

Demarcated 
not encapsulated
 lobular 
gray white 
grow into lymph nodes , renal vein

Question 25

Micro Wilms tumor

Answer 25

UnDifferentiated blastema of variable proportions primitive tubules and glomeruli spindle cell stroma aberrant epithelial differentiation (squamous ,basal ,mucinous ) in stroma mesenchymal striated muscle ,cartilage ,bone, fats anaplastic

Question 26

Wilms tumor with bad prognosis characteristics

Answer 26

Poor If anaplastic changes ,capsular invasion ,rupture at surgery ,extra renal vein invasion ,tumor implants, lymph nodes involvement ,distant metastasis, bilaterality , large size , high musing production

Question 27

In which case Wilms tumor has good prognosis

Answer 27

Children under two years old extensive tubular differentiation massive skeletal muscle differentiation

Question 28

Wilms tumor treatment

Answer 28

Nephrectomy | chemotherapy

Question 29

Five-year survival percentage in Wilms tumor

Answer 29

90%

Question 30

What are urothelial tumors

Answer 30

Benign transitional cell papillomas to malignant transitional cell carcinoma’s

Question 31

Is it easy to differentiates benign urothelial tumor from the well differentiated one

Answer 31

Difficult

Question 32

Main organ involved in urothelial tumors

Answer 32

Bladder at 90% | Renal at 5%

Question 33

Risk factors of urothelial tumors

Answer 33

Chemical implicated ( aniline dyes arylamines 2-naphthylamine, chlorinated hydrocarbons ) cigarette smoking ``` AnelGesic abuse phenacetin pelvic irritation Long term chemotherapy - cyclophosphamide hemorrhagic cystitis schistosoma hematobium ```

Question 34

Type of carcinoma caused by schistosome

Answer 34

Squamous ca 70% | TCC 30%

Question 35

Clinical manifestation of urothelial tumors

Answer 35

``` Painless Hematuria Obstruction of pelvis Pain hydronephronsis Ureter obstruction pain Bladder frequency Dysuria ```

Question 36

Macro urothelial tumors

Answer 36

Papillary | Nodular Or flat infiltrative

Question 37

Micro urothelilal tumors

Answer 37

Grading papillomas

Question 38

Grading of urothelial tumors

Answer 38

Grade I- low malignant potential (Papillary urothelial neoplasm of low malignant potential) Grade II - low grade tumor Grade III - high grade

Question 39

Prognosis urothelial tumor s

Answer 39

Depends on grade | Better when presence of blood group A, B, H