11/19- Pathology of the GU System Flashcards Preview

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Flashcards in 11/19- Pathology of the GU System Deck (92)
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1

What is seen here?

Acute pyelonephritis

2

What is seen here?

Acute pyelonephritis

3

What is seen here? 

Xanthogranulomatous Pyelonephritis

4

What is seen here?

Xanthogranulomatous Pyelonephritis

5

What are some congenital anomalies involving the kidney?

- Agenesis (absence)

- Hypoplasia (small): no scars and fewer lobules

- Ectopic (out of place)

- Horseshoe (abnormal form)

6

What is seen here? 

Horseshoe kidney

7

What can cause polycystic kidneys?

- Cystic renal dysplasia

- Polycystic kidney

- Medullary cystic kidney

- Acquired (dialysis)

8

Describe kidney structure with cystic renal dysplasia

Persistence of abnormal structures (cartilage mesenchyme, immature collecting ducts)

9

What are the forms of polycystic kidney?

Describe genetics and other features

Autosomal dominant: Adult

- High penetrance

- Bilateral, large homogeneous cysts

- Liver cysts, berry aneurysms

Autosomal Recessive: Infantile

- Longitudinal parallel peripheral cysts

- Hepatic fibrosis

10

What is seen specifically in medullary cystic kidney?

Cystic dilation of the collecting ducts

11

What can cause acquired polycystic kidneys?

Dialysis

12

What is seen here?

Polycystic kidney disease- AD

13

What is seen here? 

Polycystic kidney disease- AR

14

What is seen here?

Polycystic kidney disease- AR

15

What is urolithiasis (broadly)

Stones in urinary tract

16

Describe the common stone types, the preidsposing conditions, and their prevalence

Calcium oxalate/phosphate: 75%

- Hypercalciuria and hypercalcemia

- Hyperuricosuria

- Hypocitraturia

Magnesium ammonium phosphate (struvite): 15%

Uric acid: 6%

- Hyperuricemia/hyperuricosuria

Cystine 1-2%

17

What can predispose you to kidney stones?

- Family history

- Male gender

- Dehydration

- Urease positive bacterial infections (struvite)

18

Are the following stones radiolucent or radioopaque?

- Calcium oxalate/phosphate

- Magnesium ammonium phosphate

- Uric acid

- Calcium oxalate/phosphate: opaque

- Magnesium ammonium phosphate: opaque

- Uric acid: lucent

19

What is seen here? 

Nephrolithiasis

20

What is seen here? 

Kidney: staghorn calculus

21

What are some renal tumors?

- Renal cell carcinoma

- (Renal oncocytoma?)

- Urothelial carcinoma of renal pelvis

- Angiomyolipoma (benign)

  • Can get fairly large; if rupture, the hemorrhage may be life threatening

- Soft tissue tumors of renal capsule

  • Leiomyosarcoma

22

Describe the etiology of Renal Cell Carcinoma

- Sporadic risk factors/causes

- Syndromes

Sporadic:

- Tobacco

- Obesity

- Unopposed estrogen

Von Hippel-Lindau Syndrome (VHL gene)

- Hemangioblastoma of cerebellum and retina

- Renal cysts

- Renal cell carcinoma

23

What are the different types (and percentages) of renal cell carcinoma?

- Clear Cell Carcinoma: 80%

  • Deletion or unbalanced translocation of chromosome 3 (VHL gene) or methylation. The “internist’s tumor”.

- Chromophobe: 5%

- Papillary: 10-15%

- Collecting Duct Carcinoma (1%)

24

Describe the genetics of Von Hippel Lindau syndrome

- Gene

- Chromosome

- VHL gene

- Chromosome 3

- Caused by deletion/unbalanced translocation or methylation

25

Describe renal cancer staging

- Stage I: limited to kidney (under 7 cm)

- Stage II: limited to kidney (> 7cm)

- Stage III: beyond capsule into perinephric tissue (not beyond Gerota's fascia), major veins, adrenal gland

- Stage IV: tumor beyond Gerota's fascia, > 1 LN involved, and/or 1+ distant met

26

What is seen here?

Renal cell carcinoma: clear cell type

- Left: multilobulated tumor with hemorrhagic cut surface

- Right: yellow appearance; this yellow color is pretty diagnostic

27

What is seen here?

Renal cell carcinoma: clear cell type

- Clear space due to great amounts of fat removed during processing

28

What is seen here? 

Renal cell carcinoma: chromophobe type

29

What is seen here?

Renal cell carcinoma: papillary type

30

What is seen here? 

Renal oncocytoma

- Mahogany brown appearance