Tumors of the Kidney Flashcards
Kidney tumors may be
- Benign
- Malignant
Types of benign kidney tumors
- Renal adenoma
- Renal oncocytoma
- Angiomyolipoma
- Renal fibroma
- Mesoblastic nephroma
- Juxtaglomerular cell tumor
Renal (papillary) adenoma basics
- Common
- Metastasis can occur
Renal adenoma gross findings
- Pale yellow-gray
- Well-circumscribed nodules
Renal adenoma microscopic findings
- Papillary / complex fronds
- Tubules, glands, cords, sheets
- Cells / cuboidal to polygonal
- Regular, small central nuclei
- Scanty cytoplasm
- No atypia
Renal oncocytoma gross findings
- Benign
- Homogeneous tan / mahogany
- Well encapsulated
- Small to large (~12 cm in diameter)
- Does not metastasize
Renal oncocytoma microscopic findings
- Large, eosinophilic cells
- Small, round, benign-appearing nuclei / large nucleoli
Angiomyolipoma
Benign tumor consisting of:
- Vessels
- Smooth muscle
- Fat
Angiomyolipoma concerns
- Spontaneous hemorrhage
Angiomyolipoma prevalence
- Present in 25% to 50% of patients with tuberous sclerosis
Single most important risk factor for malignant renal cell carcinoma
- Cigarette smoking
Hereditary syndromes associated with renal cell carcinoma
- Familial Clear Cell Carcinoma
- von Hippel Landau Disease
- Hereditary Papillary RCCA
Histological categories of renal cell carcinoma
- Clear cell renal cell carcinoma
- Papillary renal cell carcinoma
- Chromophobe renal cell carcinoma
- Collecting duct renal cell carcinoma
Clear cell RCCA
- Most common type
- Arise from proximal tubular epithelium
- Solitary unilateral lesions
- Spherical masses
- Bright yellow-gray-white tissue
Clear cell RCCA gross/histological findings
- Rounded or polygonal
- Abundant clear or granular cytoplasm
- Glycogen and lipids
- Branching vasculature
- Cystic and solid areas
- Well differentiated / marked nuclear atypia
Renal cell carcinoma manifestations/clinical
- Hematuria
- Flank pain
- Mass in flank or abdomen
- Weight loss
- Fever
- Malaise
- Paraneoplastic Syndrome
Renal cell carcinoma prognosis
- Metastasis – Early Extensively (via bloodstream)
- Lung
- Soft tissues
- Bone
- Liver
Wilms Tumor (Nephroblastoma)
- Neoplasm of embryonal nephrogenic elements
- 4th most common malignancy in childhood
- 1 in 100,000 bimodal at 2.5 and 3.5
Two forms of Wilms Tumor (Nephroblastoma)
- Hereditary
- Sporadic
Hereditary syndromes related to Wilms Tumor (Nephorblastoma)
- Denys-Drash syndrome
- WAGR syndrome
- Beckwith-Wiedemann syndrome
Morphology/gross findings of Wilms Tumor (Nephroblastoma)
- Large / well circumscribed tumor
- Tan / gray mass
- Focal areas of necrosis
- Hemorrhage
- Cyst formation
Microscopic findings of Wilms Tumor (Nephroblastoma)
- Primitive / undifferentiated cells
- Primitive renal tubules
- Immature glomeruli
Manifestations/clinical presentation of Wilms Tumor (Nephroblastoma)
- Abdominal mass (most common)
- Unilateral
- Bilateral (5% sporadic, 20% familial)
- Hematuria
- Hypertension
- Abdominal pain
- Intestinal obstruction
