Tumors of urinary tract

Question 1

characteristics of acquired renal cystic disease

Answer 1

bilateral - affects all parts of kidney
gross - enlarged kidneys with cysts, papillary hyperplasia
micro -atypical epithelial proliferations

Question 2

adult polycystic kidney disease associations

Answer 2

hepatic cysts
berry aneurysms
mitral valve prolapse
cysts in pancreas 
loss of ability to concentrate urine
hypertension by age 20
hematuria

Question 3

wilms tumor (nephroblastoma)

Answer 3

usually ages 2-5
gross - large, solitary, well circumscribed mass, necrosis, cysts
spread - into perirenal soft tissue, renal vein, metastasizes into lymphatics, lung, liver, peritoneum, rarely bone
micro - triphasic with undifferentiated blastema, fibroblast like stroma

Question 4

renal cell carcinoma risk factors

Answer 4

risk factors - tb, von hippel lindau disease, renal transplantation

Question 5

variants of renal cell carcinoma

Answer 5

clear cell type 
papillary type 
medullary carcinoma 
chromophobe
sarcomatoid carcinoma 
oncocytoma

Question 6

urothelial carcinoma

Answer 6

its present with hematuria due to fragmentation within renal pelvis
associated with phenactin nephropathy, thorotrast radiologic dye/cyclophosphamide
most have preexisting bladder urothelial tumors

Question 7

urothelial carcinomas of the bladder

Answer 7

90% of bladder tumors
arise anywhere in bladder
causes are cigarettes

schistosoma haeatobium deposit ova in bladder wall > chronic inflammatory response > squamous metaplasia > dysplasia
metastases to lymph nodes, lungs

Question 8

squamous cell carcinoma of the bladder arises in

Answer 8

arises in the background of, 
chronic cystitis with squamous metaplasia 
bladder exstrophy
neurogenic bladder
chronic infection
stones
chronic indwelling catheters 
schistosoma haematobium