Urological pathology Flashcards
urinary stones can be made of?
Calcium Oxalate (Weddellite) – 75%
Magnesium Ammonium Phosphate (Struvite) – 15%
Uric Acid – 5%
which stones are related to hypercalciuria?
Calcium Oxalate
3 sources of hypercalciuria?
GUT - absorptive hyper cal
KIDNEY - proximal tubule
Primary HPTH
which are the triple stones?
Magnesium ammonium phosphate stones - struvite
what causes the formation of triple stones?
infection with urease-producing organisms
Proteus sp.
when triple stones become very large what are they called?
staghorn calculi
which stones are the following susceptible to:
Gout
Rapid cell turnover
uric acid stones
due to hyperuricaemia
where can small kidney stones become lodged at?
Pelvi-ureteric junction,
pelvic brim,
vesico-ureteric junction
Name 3 Benign Renal Neoplasms?
Papillary adenoma (epithelial)
Renal oncocytoma (epithelial)
Angiomyolipoma (mesenchymal) - blood, muscle,fat
which Benign Renal Neoplasm has the following:
15mm or less in size
Well-circumscribed
Trisomy 7, Trisomy 17, Loss of Y chromosome
Papillary adenoma
small tumour
the papillary carcinoma has the same genetic cause :)
which Benign Renal Neoplasm is:
Usually sporadic
Can be seen in Birt-Hogg-Dubé syndrome
Renal oncocytoma
which Benign Renal Neoplasm is:
Derived from perivascular epithelioid cells
Mostly sporadic
Can be seen in tuberous sclerosis
Angiomyolipoma
which Benign Renal Neoplasm is:
Larger tumours (> 4cm) may present with flank pain, haemorrhage, shock
Angiomyolipoma
Malignant kidney neoplasms are often called?
Carcinomas - they are all epithelial tumours
apart from nephroblastoma
most common renal cell carcinoma?
clear cell
how does renal cell carcinoma often present?
painless haematuria
clear cell RCC is caused by loss of which chromosome?
chromosome 3p
clear cell RCC tumour has what colour?
golden-yellow
Papillary RCC is of what size?
more than 15mm
Papillary RCC tumour has what colour?
fragile, friable (crumbled) brown tumour
which malignant Renal Neoplasm has
raisin like nuclei
Chromophobe Renal Cell Carcinoma
which malignant Renal Neoplasm is:
composed of sheets of large cells
display distinct cell borders,
reticular cytoplasm
thick-walled vascular network
Shows variable genetic aberrations
Chromophobe Renal Cell Carcinoma
how does Chromophobe RCC tumour look?
well-circumscribed solid brown tumour
ISUP Nuclear Grade (1-4) applies to which tumours?
clear cell RCC
papillary RCC
Leibovich Risk Model applies to which tumours?
what is it for?
clear cell RCC
for staging
which tumour presents as abdominal mass in children aged 2-5 years ?
nephroblastoma
aka wilms tumour
which is the second most common childhood malignancy?
nephroblastoma
aka wilms tumour
Transitional Cell Carcinomas arise in which 3 areas?
Bladder
Renal Pelvis
Ureters
which tumours are triphasic - affect 3 different cells in kidney?
nephroblastoma
aka wilms tumour
which tumours carry a number of genetic aberrations including RB and TP53?
tumour protein53
High grade
Non-Invasive Papillary Urothelial Carcinoma
NIPUC
which tumours appear as leaf/ frond-like growths?
Non-Invasive Papillary Urothelial Carcinoma
NIPUC
how does Benign Prostatic Hyperplasia present?
LUTZ: FUN HIPS
Frequency
Urgency
Nocturia
Hesitancy
Poor flow
Terminal Dribbling
or UTI, urinary retention
treatment for Benign Prostatic Hyperplasia?
§ 5a-reductase inhibitors - finasteride
§ Alpha-blockers
§ Transurethral resection
which tumour arises from Prostatic Intraepithelial Neoplasia ?
Prostatic Adenocarcinoma
which is the Most common malignant tumour in men?
Prostatic Adenocarcinoma
Which is the most powerful prognostic indicator in Prostatic Adenocarcinoma?
Gleason score
how is Gleason grading conducted?
x+y = z
Calculated by adding the top two most common patterns/grades on histological grading (or most common pattern + worst pattern)
name risk factors for Testicular Germ Cell Tumours?
Undescended testis (3-5x increased risk) Low birth weight / small for gestational age
Amplification of i12p consistent finding in ?
testicular germ cell tumours
how do Testicular Germ Cell Tumours present?
Present as painless lump
10% present with symptoms related to metastasis
which tumour has on histology:
Clear polygonal cells with lymphoid infiltrate
Seminoma
Highly sensitive to treatment regimes used for
Testicular Germ Cell Tumours ?
platinum-based chemotherapy - cisplatin, carboplatin
prognosis of Testicular Germ Cell Tumours ?
Five year survival is 98%
which tumour
Can see keratin, cartilage, epithelium – trying to form dermal layers
Post-Pubertal Teratoma
a Testicular Germ Cell Tumour
name 3 Testicular Non-Germ Cell Tumours?
Lymphoma
Leydig Cell Tumour
Sertoli Cell Tumour
which are more common T GCC or T N-GCC?
T GCC
a hydrocele consist of fluid which?
tunica vaginalis
tunica vasculosa,
tunica albuginea
tunica vaginalis
which penile disease causes Phimosis?
Lichen sclerosis/ BXO
which penile disease associated with HPV 6 and 11?
Condylomas
which paratesticular and urethral disease associated with
N. gonorrhoeae, C. trachomatis
itis!
Epididymitis
Urethritis
Fournier’s Gangrene occurs where?
scrotum
- usually immunocompromised
