Urinary - Cysts And Tumors Flashcards
-most common unifocal mass in the kidney
-fluid filled
-unilocular or with separations (divided into chambers)
-vary in size and location
-benign but can affect function
Cysts
T/F
Approx. 3% of cysts have calcifications
Calcifications can occur in benign and malignant processes
True
How will chats show in imaging?
US
Fluid filled cyst, echo free with enhanced posterior wall
CT
Region with lack of contrast enhancement
IVU
Radiopaque rim surrounding lucent cyst (beak sign)
What is the modality of choice for imaging cysts?
US
What is the treatment for cysts?
Percutaneous drainage; if indicated, an injection to collapse the cyst
-disorder in which multiple cysts cause enlargement of the kidneys with progressive renal impairment
Polycystic kidney disease
T/F
With polycystic kidney disease, the patient tends to be asymptomatic during the first 3 decades of life
True
*early diagnosis is made either by chance or as a result of a search prompted by findings in family history
What is the appearance of polycystic kidney disease in imaging?
IVU
Mottled presence of multiple lucent lesions
US
Enlarged and hyerechoic kidneys, multiple anechoic lesions
CT
Hemorrhagic cyst with increased attenuation
MRI
hemorrhagic cyst with increased signal intensity
What is the treatment for polycystic kidney disease?
No cure
Loss of kidney function - dialysis and renal transplant
-most common renal neoplasm
-usually occurs in adults over 40
-presents with painless hematuria
-originates from tubular epithelium of the renal cortex
*calcifications in 10% of the tumors
Renal cell carcinoma
What are the classic triad of symptoms for renal cell carcinoma?
-hematuria
-flank pain
-palpable abdominal mass
What is the appearance of renal cell carcinoma on an image?
IVU
localized bulging, overall renal enlargement, collecting system enlargement
US
solid mass with numerous internal echoes
Unenhanced CT
solid neoplasms, heterogenous and with similar attenuation value to normal parenchyma
Contrast CT
after injection slight increase in density due to vascular perfusion
MRI if necessary
What features make a mass malignant on an image?
Irregular margins
What are the most common sites for metastases for renal cell carcinoma?
Lungs, liver, bone, brain
What is the treatment for renal cell carcinoma?
-Nephrectomy (40%) survival rate
-irradiation and chemotherapy are ineffective in treating renal cell carcinoma
What is another name for bladder carcinoma?
Urothelial carcinoma
Previously known as “transitional cell carcinoma”
Where does bladder carcinoma originate?
Epithelium
*usually in men greater than 50
What are causes of bladder carcinoma?
-possible exposure to industrial chemicals
-cigarette smoking - carcinogenic excreted in urine (sits in bladder)
What is the treatment for bladder carcinoma?
-usually low grade malignancy, requires surgery (some tumors with reoccur)
-invasive tumors require removal of the entire bladder (urostomy)
Removal of the entire bladder
Urostomy
Imaging of the bladder with contrast (contrast by catheter)
CT cystogram
KUB imaged with contrast (IV)
Urogram
Punctuate
Dots, hole in bladder in image
How is bladder carcinoma shown in imaging?
KUB
punctuate, coarse or linear calcifications
IVU
polyp like defects with wall thickening
CT
mass projecting into bladder lumen, focal thickening of bladder wall
MRI
predicts depth of wall invasion
Cystoscopy = scope
T/F
Prostatic adenocarcinoma is also a reproductive system pathology
True
T/F
The incidence of prostatic adenocarcinoma increases with age
True
*tumor of old age
-second most common malignancy in men
-best detected by clinical rectal exam as a hard, irregular mass
Prostatic adenocarcinoma
Blood test that indicates irregularity of prostate, not necessarily malignancy
PSA - prostate specific antigen blood test
What is the treatment for prostatic adenocarcinoma?
-radical prostatectomy
-radiation therapy (seed implants)
-hormonal therapy may also be required
Where is prostatic adenocarcinoma most often located?
Peripheral parts of prostate
What is the most common metastasis location for prostatic adenocarcinoma
-local lymph nodes
-vertebrae (pelvis, lower back)
-internal organs (rectum)
-bone metastasis may be osteolytic or osteoblastic
