TUMORS Flashcards

1
Q

Q35. EXOCRINE PANCREAS TUMORS

WHAT ARE THEY?

A

Bng (adenomas, cystadenomas)
1. Serous cystadenoma
- female, 70yrs+
- cyst lined by glycogen rich cuboidal cells w. clear fluid inside
- non-specific pain, curative by resection
2. Mucinous cystadenoma
- female, body or tail of pancreas
- cysts lined w columnar-mucinous ep filled w thick mucin, thick cellular stroma
- bng, border-line or mlg
(similar to intraductal papillary mucinous neoplasm - men, head of pancreas, lack cellular stroma)

Mlg - pancreatic carcinoma
- high mortality rate, worst prognosis
- elderly >60yrs
- adenoCa arising from duct!
- strong association w smoking, chronic pancreatitis, DM
- progressive accum of genetic changes from non-neopl.–> non-invasive –> invasive
- majority head (60%) -obstructive jaundice, blocks bile duct; body (15%), rarely in tail - may remain silent, late symptoms, worse prognosis
‘Ductal adenoCa’ - most typically found
- poorly dif., aggressive, infiltrative, dense fibrotic desmoplastic stroma
- early and extensive invasion into peripancreatic tissue
- may extend to retroperitoneum
- symptoms silent until compress on sur structures e.g. spleen, adrenals etc.
- entraps adj nerves –> stomach pain etc. -pain = primary symptom
- metastasis to lungs, bone
anorexia, weakness, weight loss
Trosseau sy =migratory thrombophlebitis

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2
Q

Q37. KIDNEY TUMORS

CLASSIFY

A

Bng:

  1. adenomas
  2. angiomyolipomas
  3. oncocytoma

Mlg:

  1. Renal Cell Ca
    - Clear cell ca
    - Papillary cell ca
    - Chromophobe renal ca
  2. Nephroblastoma/ Wilm’s tu (children 2-4yrs)
  3. Renal pelvis ca
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3
Q

Q38. TUMORS OF URINARY COLLECTING SYSTEM

A
  1. Bng papilloma
  2. Urothelial (transitional) cell Ca
    Bladder = most common, others- ureter, pelvis (not so much)
    Others = sq cell Ca, adenoCa (more rare)
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4
Q

Q39. Testicular tumors

firm, painless enlargement of testes, 20-40yrs

A

Germ cell tumors (95%):

  1. Seminomas (55%) - better prognosis, metastasize late
    - classic type (most common germ cell tu)
    - spermatocytic seminoma
  2. Non-seminomas (45%) - early metastasis, worst prognosis
    - embryonal adenoCa (20-30yrs)
    - yolk sac tu (<3yrs)
    - choriocarcinoma (20-30yrs)
    - teratoma (any age)
    - mixed tu - mostly

Stromal/sex-cord tumors (5%):

  • leydig tu
  • sertoli tu

Other tumors - mlg. lymphomas, adenomatoid tu.

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5
Q

Q40. Prostate carinomca

Also know prostatitis (acute, chronic) and BPH (nodular hyperplasia..)

A
  • prostate adenoCa
  • elderly 65-75yrs
  • periphery, posterior side
  • unknown cause - genes, env, hormones plays a role
  • DRE - palpation of firm protruding mass, (size, surface, consistency).
  • macro = firm, yellowish-white mass
  • micro = diffuse, solid nests w varying anaplasia, poorly dif gls, distorted gls; tu cells - enlarged nuclei, dark cytoplasm.
  • if suspect –> transrectal biopsy (thin needle cytology/ thick needle biopsy) - microscopy, grading
  • Gleason grading system based on differentiation
  • PSA elevations >10ng/dL
  • early stages maybe silent, metastasis can be first manifestation - later urethral obstruction - micruturtion disorders, back pain etc.
  • one lobe affected –> second lobe too –> breaks through capsule –> invade seminal vesicles, metastasize to pelvic LNs, bones - osteoblastic (esp. L,Th vertebra), lungs liver etc.
  • advance = hard, fixed prostate
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