Term
| What are the most common malignant urinary tract tumors? |
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Definition
1) renal cell carcinoma
2) urothelial carcinoma
3) nephroblastoma |
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Term
| What does the term carcinoma refer to wrt tissue of origin? sarcoma? |
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Definition
1) tumor arising from epithelium
2) tumor arising from mesenchyme (fat, fibroblasts, vasculature) |
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Term
| Persistent immature tissue is associated with waht type of tumors? |
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Definition
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Term
| Give examples of benign epithelial, mesenchymal adult renal tumors |
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Definition
1) Epithelial: cortical papillary adenoma; oncocytoma
2) mesenchymal: angiomyolipoma; other |
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Term
| Give examples of malignant epithelial, lymphoid, and secondary tumors? |
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Definition
1) epithelial: renal cell carcinoma; transitional cell carcinoma
2) Lymphoid: lymphoma
3) secondary: metastatic tumors |
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Term
| Describe cortical papillary adenomas of the renal system |
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Definition
- found incidentally
- <0.5cm
- papillary; resemble papillary variant of renal cell carcinoma
- predisposing conditions: atherosclerotic renal vascular disease; long-terim hemodialysis; acquired renal cystic disease; tobacco smoking |
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Term
| Describe oncocytoma of the renal system |
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Definition
- large size
- mass or hematuria OR incidental
- large cells
- eosinophilic granular cytoplasm
- nephrectomy performed due to inability to reliably identify |
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Term
|
Definition
- mesenchymal
- clinically symptomatic
- extremely large tumors (20cm)
- massive hemorrhage
- distinctive radiological appearance
- Tuberous Sclerosis associated
- FEMALE
- PEComas - Perivascular epithelioid Cells |
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Term
| Describe Tuberous Sclerosis |
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Definition
- AD condition
- mutation in tuberin and hamartin gene
- Clinical TRIAD: Angiofibromas, Seizures, mental retardation
- may affect: CNS, Skin, Renal, Heart and Lungs, Cysts |
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Term
|
Definition
| 1) orderly mature tissue at a site where it does not usually occur |
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Term
|
Definition
| - disordered mature tissue at a site where it does not usually occur |
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Term
|
Definition
| - disordered, mature tissue at a site where it usually does occur |
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Term
|
Definition
| - tumor made up of a variety of parenchymal cell types of more than one germ layer, usually all three |
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Term
| Describe reanal cell carcinoma (RCC) |
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Definition
- adults
- mesenchymal
- MALE
- Risk factors: tobacco, renal cysts, renal dialysis
- Genetic associations: von hippel lindau syndrome, tuberous sclerosis, c3 abnormalities
- clinical triad
- mets hematogenously
- defined solid tumor w/ hemorrhage and necrosis |
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Term
| What are risk factors for renal cell carcinoma |
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Definition
- tobacco
- renal cysts, renal dialysis
- genetic associations: von hippel lindau syndrome, tuberous sclerosis, c3 abnormalities |
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Term
| Describe Von Hippel Lindau Syndrome |
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Definition
- AD
- c3p
- renal cell carcinoma
- angiomas of the retina, cerebellum
- cysts of pancreas, liver, kidneys, angiomyolipomas (rare vs. tuberous sclerosis) |
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Term
| What are the three generalizations that apply to tumors that occur in syndromes |
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Definition
1) younger age-group than in sporadic tumors
2) more frequently multiple
3) more frequently bilateral |
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Term
| What is the classic triad of symptoms associated with RCC? |
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Definition
1) abdominal mass
2) flank pain
3) hematuria |
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Term
| What are features of the clinical presentation of RCC? |
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Definition
1) classic triad: abd mass, flank pain, hematuria
2) systemic sx: fever, weight loss, malaise, anemia, neuropathy
3) paraneoplastic sx: polycythemia, hypercalcemia, HTN |
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Term
| What are frequent sites of mets for RCC? |
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Definition
- lung
-bone
-liver
-adrenals
-brain |
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Term
| Describe the gross and morphologic features of RCC |
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Definition
1) defined solid mass
2) renal pole associated
3) hemorrhage and necrosis |
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Term
What ist he most common histological type of RCC? What are characteristics:
frequency
cell of origin
cytogenetics
male:female |
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Definition
1) clear cell carcinoma
2) 70%; PCT; 3p; 1.7:1 |
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Term
| What is the prognosis of renal cell carcinoma? |
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Definition
1) poor prognosis
2) propensity to metastasize
3) frequent silent course |
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Term
| Describe transitional cell carcinoma (TCC) |
|
Definition
- bladder
- most common carcinoma occurring in the urinary tract
- adults
- M:F::3:1
- genetic associations are not significant
- hematuria; urinary sx; complications of obstruction (late)
- painless, gross hematuria in elder men
- papillary vs. flat and invasive vs. noninvasive
- propensity for recurrence |
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Term
| What are major risk factors for TCC? |
|
Definition
- tobacco
- chemicals
- industrial exposure
- schistosomiasis
- phenacetin/cyclophosphamide
- radiation |
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Term
| What are clinical features of TCC? |
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Definition
- painless, gross hematuria
- urinary sx: dysuria, frequency, urgency
- obstruction (late finding)
- elder men |
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Term
| What ist he field effect theory wrt TCC multifocal nature? |
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Definition
| 1) a carcinogen, such as a chemical excreted in the urine affects multiple areas of the bladder mucosa |
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Term
|
Definition
1) invasion of bladder wall
2) mets by lymphatics and blood vessels to nodes, lung liver, and bone |
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Term
| What is the most common renal tumor in children? |
|
Definition
|
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Term
|
Definition
- 1-4yrso
- c11
- large abd mass, hematuria, pain, HTN, - nephrogenic rest associated
- 3 component structure w/ cysts necrosis and hemorrhage
- 5 stages (not just 4)
- 90% 2yr survival |
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Term
| What are major genetic associations w/ Wilms tumor? |
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Definition
1) Beckwith-Wiedemann syndrome
2) Denys-Drash Syndrome
3) Familial Wilms
4) WAGR syndrome (Wilms tumor, Aniridia, Genital anomalies, Retardation mentally) |
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Term
| What is the precursor lesion for Wilms tumor? |
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Definition
| 1) nephrogenic rest (multiple = nephroblastomatosis) |
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Term
| What are the three components to Wilms Tumor morphology |
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Definition
1) blastema: small round blue cells
2) epithelium: primitive tubules and glomeruli
3) stroma: mesenchymal tissue |
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Term
| What is taken into consideration with the 5 stage system for staging of renal tumors? |
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Definition
| 1) surgical margin involvement is part of the staging criteria |
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