Urological pathology Flashcards
Renal cell carcinoma
- Cancer of the kidney that arises from renal tubular epithelium
- 2 types - Clear cell (75%) Papillary (10%)
Epidemiology of renal cell carcinoma
- 3% of cancers, 65-80
- PMH of smoking, obesity
Von Hippel-Lindau Syndrome
- loss of VHL gene function causes cell growth and increased cell survival
- Tumours develop in kidneys, blood vessels, pancreas
- Inherited
Presentation of renal cell carcinoma
- haematuria, palpable abdominal mass
- Paraneoplastic syndromes - Signs and symptoms that are not related to local effects of the tumour (weight loss)
Wilms’ Tumour
- Nephroblastoma - Cancer of the kidney
Epidemiology of Wilms Tumour
- Children under 5
- 5-10% genetic syndromes:
WAGR syndrome, Beckwith-Wiedemann Syndrome
Aetiology of WT
- Caused by inherited genetic mutations - WT1
Clinical features of WT
- Abdominal distention especially if bilateral (10%), haematuria
Urolithasis
- Urinary tract stones
- Usually calcium stones forming in the lumen of UT
Aetiology of Urolithiasis
- Too high conc of a solute in urine
Pathogenesis
- Too high conc of soluble material
- Urine becomes saturated
- Soluble material precipitates out
- Stones form
Clinical features of Urolithiasis
- Haematuria
- Loin to groin pain, lower abdominal pain, dysuria
Vesicoureteral reflux
- When urine flows backwards from the bladder to the ureter
Epidemiology of VUR
- 10% of population
- Young people, under 2
- Family history of VUR
Aetiology of VUR
- Congenital abnormality of Vesicoureteric junction
Pathogenesis of VUR
- Ureter enters bladder at normal angle
- When urinating, not enough muscle contraction to compress ureter
- Ureter remains patent
- Urine flows wrong way
Clinical features of VUR
- stasis = UTI
- Back pressure and ascending infection = renal damage
Urothelial Carcinoma
- Transitional cell carcinoma
- Cancer arising from urothelium
Epidemiology of Urothelial carcinoma
- Adults aged over 60
- Smokers
- Industrial chemicals
- male more than female
Urothelial carcinoma aetiology
- Environmental factors smoking, arylamines
Clinical features of Urothelial carcinoma
- Haematuria, dysuria
- Urinary obstruction
Neurogenic bladder - 2 types
- Inability to properly empty bladder due to neurological damage
- Spastic - damage to brain or spinal cord
- Flaccid - damage to peripheral nerves
Aetiology of Neurogenic bladder
- Damage to nervous system
- Stroke, MS
- Diabetes, pregnancy
Pathogenesis of NB
- Disruption to afferents from stretch receptors or efferents to internal sphincter
Clinical features of NB
- Urinary retention, abdominal distention
- Can cause UTI, urinary stones, renal function impairment
