UROLOGICAL PATHOLOGY

Question 1

RENAL CANCER
Definition
epidemiology
Aetiology
pathogenesis
Key clinical features

Answer 1

1) Renal cell carcinoma
- 3% of cancers.
Causes: von hippel lindau syndrome, risk factors of smoking, obesity and hypertension.
Presentation: palpable abdo mass, haematuria.
more males then females 3:2.
Majority are clear cell = well defined yellow tumouts with haemorrhagic areas.

Question 2

BLADDER CANCER
Definition
epidemiology
Aetiology
pathogenesis
Key clinical features

Answer 2

Tumours of the lining cells = Urothelial cell carcinoma is 95% of bladder tumours. most common in bladder but may arise in urthethra or renal pelvis.
Presentation: Haematuria, urinary requency, pain on urination.
Recurrances are common.
Low grade TCC 98% alive at 5 years. Muscle invasion = 60% 5 year survival.

Question 3

Obstructive lesions of the urinary tract:
Common causes,
Clinical presentation
Complications

Answer 3

1) Can occur anywhere from renal pelvis to urethreal meatus. Onset may be chronic or acute, unilateral or bilateral.
Common causes:
Obstruction within the lumen: Urinary calculi, Strictures (post-procedure, post-infective, congenital), Neoplasia
Abnormalities of the wall: Neoplasia (benign or malignant), Congenital anatomical abnormalities
External compression: Tumour outside the urinary tract
Inflammatory conditions (retroperitoneal fibrosis), Pregnancy
Functional obstruction: Neurological conditions, Severe reflux.
Clinical features: Acute bilateral obstruction: Pain, Acute renal failure and anuria. Chronic unilateral obstruction: Asymptomatic initially. If unresolved cortical atrophy and reduced renal
Complications: Acute renal failure, Ca stones.

Question 4

Paraneoplastic syndromes

Answer 4

Clinical syndromes that result from substances produced by tumours. Not related to the tissue that the tumour arose from. Not related to invasion by the tumour itself or its metastases
Paraneoplastic syndromes associated with RCC: Cushing’s, hypercalcaemia, erythropoietin