Tumors of the Kidney & Urinary Tract Flashcards
How does a clear cell carcinoma appear grossly?
a single, spherical, yellow-gray mass with focal hemorrhages
Most common cytogenetic abnormalities in papillary carcinoma are ______.
- trisomies 7, 16, and 17
- loss of Y
What is the most rare benign tumor of the kidney?
metanephric adenoma
The VHL gene encodes a protein that is part of a _______ complex involved in targeting other proteins for degradation.
ubiquitin ligase
What is the prognosis for Collecting Duct (Bellini duct) Carcinoma?
poor
This benign tumor of the kidney consists of vessels, smooth muscles, and fat.
angiomyolipoma
What does RCC stand for?
renal cell carcinoma
What is the prognosis for Chromophobe Renal Carcinoma?
excellent
Current studies implicate the _____ gene in the development of both familial and sporadic clear cell tumors.
VHL (Von Hippel-Lindau)
Where does chromophobe renal carcinoma grow from?
intercalated cells of collecting ducts
What does TCC stand for?
transitional cell neoplasm
What tumors comprise Von Hippel-Lindau (VHL) syndrome?
- hemangioblastomas of the cerebellum
- retina renal cysts
- bilateral RCCs
How is RCC further categorized?
- clear cells, granular cells, or a mixture
- Fuhrman’s Criteria = 1-4, with higher # being worse
- Spindle cell types or sarcomas spread most quickly
The average 5-year survival rate of patients with renal cell carcinoma is about ____%.
45
A tumor of the kidney consisting of EOs and epi cells with numerous mitochondria is called?
an oncocytoma
Where does RCC arise from?
the renal epithelium
What is the most common tumor of the urinary tract?
transitional cell neoplasms (TCC)
Where does renal fibroma/hamartoma occur?
in the pyramids
Clear CC more often occurs in males or females?
males
Where does Collecting Duct (Bellini duct) Carcinoma arise from?
from collecting duct cells in the medulla
Who gets transitional cell neoplasms of the urinary tract?
- 50 -80 year olds
- Males
- pts from urban areas
- smokers
- pts exposed to acrylamide (2-snaphthylamine)
- Hx of Schistosoma haematobium infections in Egypt and Sudan
- Pts exposed to radiation
What do oncocytomas consist of?
- EOs
- epi cells with numerous mitochondria
What makes up an angiomyolipoma?
- vessels
- smooth muscles
- fat
Where does renal papillary adenoma occur?
in the cortex
Unlike clear cell RCCs, ______ are frequently multifocal.
papillary carcinomas
What is the most common malignant tumor of the kidney?
renal cell carcinoma (RCC)
About 95% of urinary tract tumors are of ______ origin, the remainder being ______ tumors.
epithelial; mesenchymal
Most common cytogenetic abnormalities in ______ are trisomies 7, 16, and 17 and loss of Y.
papillary carcinoma
______ tend to grow and spread more quickly than the other kinds of RCCs and thereby have a poor prognosis.
Spindle cell types or sarcomas
Where is the VHL (Von Hippel-Lindau) gene located?
short arm of chromosome 3
What is the median survival time for a pt with metastatic kidney cancer?
13 months
Are most cases of RCC sporadic or genetic?
sporadic
What is the 2nd most common malignant tumor of the kidney, and who gets it?
Wilms tumor; children
What does renal papillary adenoma look like?
small, well circumscribed nodules within the cortex
What is the tx for RCC?
nephrectomy or partial nephrectomy
How does clear CC look on imaging?
- a ball-like mass of renal cortex
- usually a single tumor
Dx?
- Cells with prominent cell membranes and pale eosinophilic cytoplasm
- usually with a halo around the nucleus
Chromophobe Renal Carcinoma
Where does transitional cell neoplasm (TCC) metastasize to?
- lungs
- bones
- liver
How does a pt with transitional cell neoplasm (TCC) clinically present?
- hematuria
- irritative bladder symptoms such as dysuria, urinary frequency, and urgency
Where does clear cell carcinoma most often metastasize?
- renal vein
- IVC
- heart
- lungs
Which benign tumor is always surgically removed bc it’s considered “early cancer?”
renal papillary adenoma
Describe the histological appearance of Chromophobe Renal Carcinoma.
- Cells with prominent cell membranes and pale eosinophilic cytoplasm
- usually with a halo around the nucleus
