Tumors of Kidney and Urinary Tract

Question 1

benign tumors rarely ___

Answer 1

cause problems

Question 2

malignant tumors order of prevalence

Answer 2

1) RCC
2) Wilsm
3) urothelial tumors of calyces and pelvis

Question 3

Benign tumors

1) located in cortex
2) small (5 mm)
3) surgically removed

Answer 3

renal papillary adenoma

Question 4

Benign tumors
1) fibrous
2)

Answer 4

renal fibroma/hamartoma

renomedullary interstitial cell tumor

Question 5

Benign tumors

1) vessels, smooth muscle, fat
2) 25-50% in patients with tuberous sclerosis

Answer 5

angiomyolipoma

Question 6

Benign tumors

1) eosinophilic epith cells
2) numerous mitochondria
3) 5-15% of all renal neoplasmas
4) in families

Answer 6

oncocytoma

Question 7

Benign tumors

1) rare
2) metasizes

Answer 7

metanephric adenoma

Question 8

1) most common RCC
2) hematuria, renal mass on imaging
3) in renal cortex –> invades renal vein –> IVC
spread to nodes, lungs

Answer 8

clear cell carinoma

Question 9

imaging

1) ball mass of renal cortex
2) engorged renal vein + IVC

Answer 9

clear cell carcinoma

Question 10

histology

1) single tumor, spherical
2) 3 cell types = clear, granular spindle

Answer 10

clear cell RCC

Question 11

familial assoc with VHL (4%

sporadic 95%

98% lose sequences on short arm chromosome 3

Answer 11

clear cell carcinoma

Question 12

tumor grades 1-2 have ___ prognosis compared to tumors 3-4

Answer 12

better

Question 13

10-15% of RCC
Pathology
Frequently multifocal (multi-cell)
papillary growth pattern

Answer 13

papillary carcinoma

Question 14

genetics
familial + sporadic
NOT 3p deletions
Trisomies 7, 16, 17, loss of Y

Answer 14

papillary carcinoma

Question 15

mutated gene on chromosome 7 (MET locus = protooncogene for tyrosine kinase receptor)

Answer 15

papillary carcinoma

Question 16

5% of renal cell cancers

prominent cell membranes
pale eosinophilic cytoplasm
halo around nucleus

Answer 16

chromophobe renal carcinoma

Question 17

genetics
multiple chromosome losses
hypodiploidy

from intercalated cells

Answer 17

chromophobe renal carcinoma

Question 18

chromophobe renal carcinoma has a ___ prognosis compared to clear cell and papillary cancers

Answer 18

better

Question 19

1% of renal epithelial neoplasms
arises from collecting duct cells in medulla

nests of malignant cells in fibrotic stroma (medulla)

Answer 19

collecting duct carcinoma

Question 20

best method for prolonging patient survival with collecting duct carcinoma

Answer 20

early detection

Question 21

4% of renal cancers

names of familial RCC

Answer 21

1) VHL syndrome
2) hereditary familial clear cell carinoma
3) hereditary papillary carcinoma

Question 22

VHL symptoms

develop ….

Answer 22

hemangioblastomas of cerebellum and retina

renal cysts and bilateral renal cell carcinomas

Question 23

hereditary clear cell carcinoma confined to …

Answer 23

kidney

Question 24

hereditary papillary carcinoma
inheritance?
manifests as?
mutations in…

Answer 24

autosomal dominant

mutliple bilateral tumors

MET protooncogene

Question 25

T indicates …
N indicates …
M indicates …

Answer 25

T = tumor’s size and spread to nearby tissues

N = cancer spread to nodes near kidney

M = metastasize

Question 26

95% of urinary tract tumors are of ___ origin

5% of urinary tract tumors are of ___ origin

Answer 26

epithelial

mesenchymal

Question 27

most epith tumors are composed of ___ cells and also called ___

Answer 27

urothelial (transitional) cell

Question 28

benign neoplasms of urinary tract are represented by small tumors of ___ origin

Answer 28

mesenchymal

Question 29

2 most common benign neoplasms

Answer 29

fibroepithelial polyps

leiomyomas

Question 30

fibroepithelial polyps presents as ____

more commonly in the ___

Answer 30

small mass project into lumen

left ureter > right

Question 31

80% btwn 590-80
smokers
industrial exposures and radiation

Answer 31

transitional cell neoplasm

Question 32

> 90% of tumors from urinary tract including squamous cell and adenocarcinoma

Answer 32

transitional cell neoplasms

Question 33

presents with hematuria and dysuria, freq, urgency

Answer 33

transitional cell neoplasm

Question 34

arises from calyces, pelvis, ureters, bladder, urethra, and extend to pelvic sidewalls and go to lungs, bones, liver

Answer 34

transitional cell neoplasm

Question 35

tumor causing ureteral obstruction –> hydroenphrosis (unilateral or bilat)

Answer 35

transitional cell neoplamss

Question 36

filling defect in urinary tract on imaging

purely papillary to nodular or flat

Answer 36

transitional cell neoplasm

Question 37

therapy for transitional cell neoplasm

Answer 37

1) BCG
2) electrocautery
3) surgery