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5. URINARY > URINARY Section 2: Renal Masses > Flashcards

URINARY Section 2: Renal Masses Flashcards

1
Q

The most common primary renal malignancy

A

RCC

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2
Q

RCC til proven otherwise:

A

a. enhancing mass (>15 HU)
b. Fatty mass + calcs

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3
Q

Risk factors of RCC

A

Smoking
Von Hippel Lindau
Chronic disalysis (>3 years)
Family Hx

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4
Q

Metastatic charatecerisitcs of RCC

A

Hypervascular mets

Bone metes = Always lytic

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5
Q

The most sensitive phase for detection of RCC in CT

A

Nephrographic phase (80 secs)

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6
Q

RCC + fat

A

Clear cell

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7
Q

RCC subtypes

A
  1. Clear cell
  2. Papillary
  3. Medullary
  4. Chromophobe
  5. Translocation
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8
Q

Most common subtype of RCC in the general population

A

Clear Cell

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9
Q

RCC + VHL =

A

Clear Cell

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10
Q
A

Clear Cell

Corticomedullary Enhancement = cortex

Cystic mass + Enhancing components

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11
Q

This is the second most common type of RCC

A

Papillary

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12
Q
A

Papillary RCC

Less aggro than CCC

Less vascularity will not enhance = to cortex on CMP

T2 Dark

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13
Q

What RCC subtypes risk do transplented kidneys have?

A

Papillary subtypes.

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14
Q

RCC + Sickle Cell =

A

Medullary RCC

Highly aggressive + usuallry large with mets on DX

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15
Q

Birt Hoog Dube (autosomal dominant genodermatosis, usually manifesting in the third decade of life with multiple fibrofolliculomas, trichodiscomas, and acrochordons)

A

Chromophobe RCC

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16
Q

Most common RCC subtype in kids.

A

Translocation RCC

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17
Q

Hx Cytotoxic chemotherapy

A

Translocation RCC

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18
Q

Conventional RCC Staging:

Stage 1:

A

Limited to Kidney and < 7 cm

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19
Q

Conventional RCC Staging:

Stage 2:

A

Limited to Kidney and > 7 cm

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20
Q

Conventional RCC Staging:

Stage 3:

A

Still inside Gerota’s Fascia
A: renal vein invaded
B: IVC below diaphragm
C: IVC above diaphragm

21
Q

Conventional RCC Staging:

Stage 4:

A

Beyond Gerota’s Fasica
Ipsilateral Adrenal

22
Q

Overall Most Common in Gen Pop + Von Hippel-Lindau

A

Clear Cell

23
Q

Does ADPKD increase your risk of RCC?

A

Nope

Dialysis does!

24
Q
A

Renal Lymphoma

most common appearance is bilaterally, enlarged kidneys, with small, low attenuation cortically based solid nodules or masses

“infiltrative soft tissue in the renal hilum”

+ lymph nodes

Solitary mass - 25%

25
Q

Most common metastatic tumor to invade the kidneys

A

Lypmphoma

26
Q

Renal Leukemia

A

The kidney is the most common visceral organ involved

27
Q

the most common benign tumor of the kidney

A

Angiomyolipoma (AML)

28
Q

Macroscopic fat

A

Angiomyolipoma

29
Q

Tuberus sclerosis

A

Angiomyolipoma

30
Q

Angiomyolipoma bleeds at this size

A

> 4cm

more in pregnancy

31
Q

Never have calcificaitons

A

Angiomyolipoma

32
Q
A

T2 Dark

Angiomyolipoma

33
Q

AML on MRI

A

Fat Sat or IP OOP

34
Q

Renal mass + Fat + Calcifications =

A

RCC

35
Q

Renal mass + Fat - Calcifications =

A

Probably AML

36
Q

This is the 2nd most common benign tumor (after AML).

A

Oncocytoma

37
Q

MASS + Central scar =

A

Oncocytoma

RCC until proven otherwise

38
Q
A

Oncocytoma

CT/MRI Solid mass + Central Scar

39
Q
A

Oncocytoma

USD: “Spoke wheel” Vascular pattern

40
Q

if you are shown an enhancing renal mass with a central scar, how do you decide if it’s a RCC or an oncocytoma?

A

all enhancing renal masses are RCC till proven otherwise

If cetnral scar = consider oncocytoma

41
Q

Birt Hogg Dube associated solid renal masses

A

Oncocytoma (Bilateral)

Chromophobe RCC

42
Q
A

Multilocular Cystic Nephroma

“Non-communicating, fluid-filled locules, surrounded by thick fibrous capsule.”

By definition these things are characterized by the absence of a solid component or necrosis.

43
Q

“protrudes into the renal pelvis.”

A

Multilocular Cystic Nephroma

44
Q

Multilocular Cystic Nephroma is common in these ages

A

4 y.o BOYS
40 y.o. women

45
Q

Micheal jackson lesion

A

Multilocular Cystic Nephroma
loves young boys and middle aged women

46
Q

retroperitoneum borders

A

anterior - anterior parearenal space
posterior - transversalis fascia

47
Q

What part of the pancreas is not included in the retroperitoneum

A

Tail

48
Q

What part of the rectum is not included in the retroperitoneum

A

Lower 1/3.

5. URINARY (19 decks)

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