tumors of the kidney and urinary tract Flashcards
renal parenchyma tumors occurs mostly in the
cortex
angiomyolipoma
soft tissue surrounding the kidney tumor
renal tumors in adults (3)
- oncocytoma
- angiomyolipoma
- renal cell carcinoma: clear cell, papillary and chromphobe
renal tumors in children
nephroblastoma- Wilms’ tumor
oncocytoma:
- neoplams of the
- tumor composed of
- tumor cells often grow in
- tumor cells present in
- true or false: tumors are small
- 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
angiomyolipoma
a. benign neoplasm compose of
b. origin from
c. occurs more in
d. association with
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
renal cell carcinoma:
- malignant neoplasm that arise from the
- ____ of malignancies in adults
- peak incidence ______ decade
- most common in
- arises from the epithelium of renal tubules of both cortex and medulla
- 3% malignancies in adults
- peak incidence 6th decade
- more common in men
risk factors in RCC (6)
- von Hippel-Lindau syndrome
- tuberous sclerosis
- tobacco use
- HTN
- obesity
- hemodialysis
clinical features of RCC:
- classic triad
- non-specific symptoms
- paraneoplastic syndromes
- occurs in 30% of patients
- triad: - hematuria - flank pain - flank mass
- fever, weight loss, fatigue
- polycythemia, hypercalcemia
- metastatic disease
classification of RCC (3)
- clear cell- conventional type
- papillary
- chromophobe
prognosis of RCC
- chromophobe vs clear cell vs papillary
- fuhrman grade
- stage
- survival decreases with chromophobe> papillary> clear cell
- fuhrman grade: 1-4, dependent of nuclear features
- stage: TNM
nephroblastoma (wilm’s tumor)
- embryonal neoplasm derived from
- most common in
- 98% occur
- more commin in
- derived from nephrogenic blastema cells
- common in children
- occurs <10 yr of age
- more common in girls
syndrome Risk factors in Whilms tumor and %
- WAGR- 30%
- Denys-Drash- 90%
- Beckwith- Wiedemann ?%
clinical features in Whilms
- abdominal mass
- pain
- hematuria
- HTN
- traumatic rupture
prognosis of nephroblastoma (whilms)
- age
- stage
- grade
- >2 yr worse
- i- confined to kidney, ii- beyond kidney, iii- residual non-hematogenous tumor in abdomen, iv- hematogenous metastases , v- bilateral tumor
- grade: nuclear features
benign urothelial neoplasia
urothelial papilloma
malignant urothelial neoplasia (3)
- papillary neoplasms
- urothelial carcinoma in situ
- invasive urothelial carcinoma
what us happening with urothelial papilloma
rare, occurs in the young, usually a single tumor/lesion with normal urohtelium on top of a fibroblastic core
tumor carcinoma
- arises from
- most frequently in
- most common in __yr
- more common in
- arises from urothelium
- occurs in bladder
- 65 yr
- men
risk factors in urothelial carcinoma
- tobacco smoking
- occupational exposure to chemicals such as aniline dyes and aromatic amines
clinical presentation of urothelial carcinoma
- hematuria
evaluation/managment of urothelial carcinoma
- urine cytology
- cystoscopy
- biopsy/transurethral resection
- radiologic studies
prognosis of urothelial carcinoma
- type of tumor
- papillary neoplasm>in-situ carcinoma>invasive carcinoma

oncocytoma- tan, well circumscribed, benign

nests of tumor cells associated with oncocytoma

oncocytoma with many mitochondria and they are granula

angiomyolipoma- well circumscribed

angiomyolipoma

clear cell RCC

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

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

papillary RCC

papillary- notice the foamy macrophages

papillary with fribroblastic core

chromophobe RCC notice how well circuscribed and looking like a oncocytoma

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

RCC-T1

RCC- T2

RCC- we see penetration of capsule

tumor in renal vein

Whilms tumor

whilms tumor

blastem associated with whilms

epithelium and stroma associated with whilms

nests of embryonic kidney- perilobar nephroblastomatosis

urothelial papilloma

papillary urothelial carcinoma

high grade papillary urothelial carcinom

high grade papillary urothelial carcinoma

flat urothelial carcinoma in situ

possible carcinoma in situ of the urothelium

normal urothelium

urothelial carcinoma in-situ