tumors of the kidney and urinary tract Flashcards

1
Q

renal parenchyma tumors occurs mostly in the

A

cortex

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2
Q

angiomyolipoma

A

soft tissue surrounding the kidney tumor

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3
Q

renal tumors in adults (3)

A
  1. oncocytoma
  2. angiomyolipoma
  3. renal cell carcinoma: clear cell, papillary and chromphobe
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4
Q

renal tumors in children

A

nephroblastoma- Wilms’ tumor

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5
Q

oncocytoma:

  • neoplams of the
  • tumor composed of
  • tumor cells often grow in
  • tumor cells present in
  • true or false: tumors are small
A
  • benign epithelial neoplams
  • tumor composed of oncocytic cells that are eosinophilic and granular cytoplasm
  • tumor cells often grow in nest sand cords
  • tumor cells present in a myxoid stroma
  • false: they can be very large
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6
Q

angiomyolipoma

a. benign neoplasm compose of
b. origin from
c. occurs more in
d. association with

A

a. composed of blood vessels, smooth muscle and adipose tissue
b. origin from perivascular epithelioid cell
c. more common in female
d. association with tuberous sclerosis

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7
Q

renal cell carcinoma:

  • malignant neoplasm that arise from the
  • ____ of malignancies in adults
  • peak incidence ______ decade
  • most common in
A
  • arises from the epithelium of renal tubules of both cortex and medulla
  • 3% malignancies in adults
  • peak incidence 6th decade
  • more common in men
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8
Q

risk factors in RCC (6)

A
  1. von Hippel-Lindau syndrome
  2. tuberous sclerosis
  3. tobacco use
  4. HTN
  5. obesity
  6. hemodialysis
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9
Q

clinical features of RCC:

  1. classic triad
  2. non-specific symptoms
  3. paraneoplastic syndromes
  4. occurs in 30% of patients
A
  1. triad: - hematuria - flank pain - flank mass
  2. fever, weight loss, fatigue
  3. polycythemia, hypercalcemia
  4. metastatic disease
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10
Q

classification of RCC (3)

A
  1. clear cell- conventional type
  2. papillary
  3. chromophobe
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11
Q

prognosis of RCC

  • chromophobe vs clear cell vs papillary
  • fuhrman grade
  • stage
A
  • survival decreases with chromophobe> papillary> clear cell
  • fuhrman grade: 1-4, dependent of nuclear features
  • stage: TNM
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12
Q

nephroblastoma (wilm’s tumor)

  • embryonal neoplasm derived from
  • most common in
  • 98% occur
  • more commin in
A
  • derived from nephrogenic blastema cells
  • common in children
  • occurs <10 yr of age
  • more common in girls
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13
Q

syndrome Risk factors in Whilms tumor and %

A
  1. WAGR- 30%
  2. Denys-Drash- 90%
  3. Beckwith- Wiedemann ?%
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14
Q

clinical features in Whilms

A
  1. abdominal mass
  2. pain
  3. hematuria
  4. HTN
  5. traumatic rupture
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15
Q

prognosis of nephroblastoma (whilms)

  1. age
  2. stage
  3. grade
A
  1. >2 yr worse
  2. i- confined to kidney, ii- beyond kidney, iii- residual non-hematogenous tumor in abdomen, iv- hematogenous metastases , v- bilateral tumor
  3. grade: nuclear features
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16
Q

benign urothelial neoplasia

A

urothelial papilloma

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17
Q

malignant urothelial neoplasia (3)

A
  1. papillary neoplasms
  2. urothelial carcinoma in situ
  3. invasive urothelial carcinoma
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18
Q

what us happening with urothelial papilloma

A

rare, occurs in the young, usually a single tumor/lesion with normal urohtelium on top of a fibroblastic core

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19
Q

tumor carcinoma

  1. arises from
  2. most frequently in
  3. most common in __yr
  4. more common in
A
  1. arises from urothelium
  2. occurs in bladder
  3. 65 yr
  4. men
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20
Q

risk factors in urothelial carcinoma

A
  1. tobacco smoking
  2. occupational exposure to chemicals such as aniline dyes and aromatic amines
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21
Q

clinical presentation of urothelial carcinoma

A
  1. hematuria
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22
Q

evaluation/managment of urothelial carcinoma

A
  1. urine cytology
  2. cystoscopy
  3. biopsy/transurethral resection
  4. radiologic studies
23
Q

prognosis of urothelial carcinoma

  1. type of tumor
A
  1. papillary neoplasm>in-situ carcinoma>invasive carcinoma
24
Q
A

oncocytoma- tan, well circumscribed, benign

25
Q
A

nests of tumor cells associated with oncocytoma

26
Q
A

oncocytoma with many mitochondria and they are granula

27
Q
A

angiomyolipoma- well circumscribed

28
Q
A

angiomyolipoma

29
Q
A

clear cell RCC

30
Q
A

clear cell RCC- notice the low grade due to the nuclei looking the same and clear cytoplasm

31
Q
A

clear cell RCC- notice the tubular growth, eosinophilic cytoplasm indicating a high grade tumor

32
Q
A

papillary RCC

33
Q
A

papillary- notice the foamy macrophages

34
Q
A

papillary with fribroblastic core

35
Q
A

chromophobe RCC notice how well circuscribed and looking like a oncocytoma

36
Q
A

chromophobe- notice the diffuse sheets with large and small cells with clear and eosinophilic alt. cytoplasm

37
Q
A

RCC-T1

38
Q
A

RCC- T2

39
Q
A

RCC- we see penetration of capsule

40
Q
A

tumor in renal vein

41
Q
A

Whilms tumor

42
Q
A

whilms tumor

43
Q
A

blastem associated with whilms

44
Q
A

epithelium and stroma associated with whilms

45
Q
A

nests of embryonic kidney- perilobar nephroblastomatosis

46
Q
A

urothelial papilloma

47
Q
A

papillary urothelial carcinoma

48
Q
A

high grade papillary urothelial carcinom

49
Q
A

high grade papillary urothelial carcinoma

50
Q
A

flat urothelial carcinoma in situ

51
Q
A

possible carcinoma in situ of the urothelium

52
Q
A

normal urothelium

53
Q
A

urothelial carcinoma in-situ