tumors and anomalies Flashcards
classic triad of renal cell carcinoma
hematuria
pain
flank mass
4 types of renal tumors
renal adenocarcinoma (renal cell carcinoma)
embryonal tumor (nephroblastoma- wilms tumor)
mesenchymal tumors
tumor like conditions
bilateral percentage
0.5-1.5%
multiple tumors
4.5%
types of renal cell carcinoma
clear cell
papillary adenocarcinoma
chromophobe
other
clear cell carcinoma
80% highly vascular (massive hem) full of neutral (yellow lipids glycogen) that dissolves on prep
pap adenocarcinoma
10%
micropapillae protrude
foam celsl in walls
chromophobe
mosaic of pale cytoplasm and thick walls near capillaries
sarcomatoid differentiation
potential outcome of any RCC that represnts a very aggressive stage with poor px
cells spindled but epithelial (+ keratin)
what is the difference between carcinoma and adenoma
adenoma is smaller (<2-3 cm) therefore less malignant mostly papillary (and thus slow growing)
nephroblastoma is found primarily in
kids
clinical presentation of nephroblastoma
palpable mass
hypertension
pain
path of nephroblastoma
blastema cells, epithelial cells, stromal cells all in different ratios
what does thsi tumor persist from
metanephric blastema
two growth patterns of urothelial lined tumors
papillary (verticle) or carcinoma (flat)
clinical presentation of baldder cancer
hematuria, pain, freq, dysuria
can present by blockage and ureteritis and hydronephrosis
papillary urothelial carcinoma gross
cauliflower like configurations
papillary urothelial LM
fringe-like surface because of papillary fronds, pale pink fibrovascular core covered by urothelium
low grade papillary tumors
elongated papillae with less crowded cells
high grade papillary tumors
smaller, condesnced papillae with highly crowded, large, hyperchromic and anaplastic cells with mitotic figures
CIS has a___
higher risk of invasion because flat
Ta staging
no invasion
T1
invasion lamina propia
T2
invasion muscle
T3
invasion of fat
T4
lymph node involvement
T2 or more
requires removing bladder vs local resection in non-muscle invasive tumors
bladder VA tx
topical- BCG, thiotepa, mitomycin C
radiation for invasion
surgery
chemo
upper urotheial tract cancer presents
hematuria
treatment uut cancer
standard nephrourectomy with bladder cuff segment
