Warren- Renal Tumors Flashcards
What are the two benign renal tumors?
angiomyolipoma
oncocytoma
What is an angiomyoplipoma composed of?
VESSELS
SMOOTH MSUCLE
FAT
What is angiomyolipoma associated with?
Tuberus sclerosis
Autosomal dominant
A big mahogany brown tumor may be…
oncocytoma
What is seen microscopically in an oncocytoma?
large
EOSINOPHILIC CELLS w/
round nuclei
abundant mitochondria
Where do most oncocytoma arise from?
collecting duct
What percent of renal neoplasms are oncocytomas?
5-15%
What is the most common important risk factor for renal cell carcinoma?
tobacco use
What constitutes 85% of renal cancer in adults?
Renal cell carcinoma
What is Von hippel lindau syndrome?
Autosomal dominant
Hemangioblasoma of cerebellum/retina
renal cysts/renal carcinoma
What is the defect in VHLS?
VHL gene>
encodes protein of ubiquitin ligase complex (targets proteins for degradation)>
proteins that increase trx/promote angiogenesis aren’t degraded
What is the most common type of renal cell carcinoma?
Clear cell
What chromosome abnormality is associated w/ Clear cell?
loss of chromosom 3p
What does a clear cell tumor look like?
BRIGHT YELLOW tumor
Abundant clear/granular cytoplasm
What is papillary carcinoma?
10-15% of RCC
Papillary growth pattern and foam cells in papillary core
What is a chromophobe carcinoma?
Vegetable like cells with PROMINENT CELL MEMBRANES
Where do RCCs usually grow?
Often invade the RENAL VEIN
What is hte calssic presentation for RCC?
Only seen in 10% of pts: flank pain, palpable mass, hematuria
USUALLY asymptomatic for a long time
A pt presents w/ polycythemia, hypercalcemia, HTN, hepatic dysfunction, feminization/masculinization. What might they have?
RCC which commonly causes PARANEOPLASTIC SYNDROMES
What percent of RCC pts have metastasis at presentation and what is hte most common met location?
25%
Lung, then bone
How do urothelial carcinomas present?
Usually arise in the renal pelvis>
Often multiple>
Early hematuria
