Histopathology 9 - Urological pathology

Question 1

What is the most common composition of urinary calculi?

Answer 1

Calcium oxalate

AKA Weddelite

Question 2

What is the most likely cause of calcium oxalate urinary calculi?

Answer 2

Hypercalciuria

Either due to excessive Ca absorption from gut or impaired absorption in nephron

Question 3

What are magnesium ammonium phosphate urinary calculi also known as?

Answer 3

Triple stones

Question 4

What is the cause of triple stones AKA Magnesium ammonium phosphate ?

Answer 4

A consequence of infection with urease-producing organisms

Urease –> ammonia increase

Ammonia makes urine alkaline –> triple stone precipitation

Question 5

Why might a small urinary stone become symptomatic?

Answer 5

If it gets out of kidney and gets into the ureter - it will cause colic at any point where the ureter bends

Question 6

What type of urinary calculi are caused by gout?

Answer 6

Uric acid stones

Question 7

What is papillary adenoma of the kidney?

What size are they?

Answer 7

Benign epithelial kidney tumour composed of papillae and/or tubules

ALWAYS 15MM OR LESS IN SIZE

Question 8

What is a renal oncocytoma?

What does histology show?

Answer 8

Benign epithelial kidney tumour composed of oncocytic cells

Histology: Oncocytes are the large cells with pink granular cytoplasm and a prominent nucleolus

Question 9

What syndrome should be considered in a patient with many renal oncocytomas?

Answer 9

Birt-Hogg-Dubé syndrome

Question 10

What is an angiomyolipoma?

Answer 10

Benign mesenchymal kidney tumour composed of thick-walled blood vessels, smooth muscle and fat

NB Angio= blood, myo= muscle, lipo= fat

Question 11

In what condition are angiomyolipomas most likely to appear?

Answer 11

Tuberous sclerosis

Question 12

What is a renal cell carcinoma?

Answer 12

Malignancy of epithelial cells of proximal convuluted tubule

Question 13

What is the main symptom of renal cell carcinoma?

Answer 13

Painless haematuria

NB Most of the remaining cases are detected incidentally on imaging

Question 14

What is the most common subtype of renal cell carcinoma?

Answer 14

Clear cell renal cell carcinoma (70%)

other types = papillary cell (15%) + chromophone (5%)

Question 15

What is the genetic association of Clear Cell Renal Cell Carcinoma?

Answer 15

Loss of chromosome 3p

Question 16

What is Nephroblastoma also known as?

Answer 16

Wilm’s tumour

Question 17

How does nephroblastoma typically present?

Answer 17

Abdominal mass in children aged 2-5

Question 18

What is the new name for transitional cell carcinoma?

Answer 18

Urothelial carcinoma

Question 19

What are the 2 main treatments of BPH?

Answer 19

5 alpha reductase inhibitors
Alpha blockers

Question 20

What score is used for prostatic adenocarcinoma?

Answer 20

Gleason score

Question 21

What is the most common type of testicular tumour?

Answer 21

90% = germ cell

Question 22

Recall 2 risk factors for testicular germ cell tumours

Answer 22

Undescended testes
Low birth weight

Question 23

What are the histological subtypes of germ cell testicular tumour?

Answer 23

Seminoma
Embryonal carcinoma
Post-pubertal teratoma: THIS IS MALIGNANT
Yolk Sac Tumour

Question 24

What is the most useful form of chemo in germ cell testicular tumours?

Answer 24

Platinum based

Question 25

What are the 3 subtypes of non-germ cell testicular tumours?

Answer 25

Lymphoma Leydig cell Sertoli cell

Question 26

Which type of testicular tumour can present with precocious puberty?

Answer 26

Leydig cell

Question 27

What is flat urothelial carcinoma in situ?

Answer 27

Very high grade lesion with high risk of progression into invasive tumour See reddish area

Question 28

Which testicular germ cell tumour has clear polygonal cells and a lymohcytic inflitrate?

Answer 28

Seminoma

Question 29

Which type of urinary stone is most likely to develop into a massive "staghorn calculus"?

Answer 29

Triple stone AKA Magnesium ammonium phosphate (Struvite)

Question 30

What is the typical histological appearance of non-invasive papillary urothelial carcinoma?

Answer 30

Frond-like growths

Question 31

What is the typical histological appearance of a seminoma?

Answer 31

Clear polygonal cells and lymphocytic infiltrate

Question 32

Which kidney cancer has golden-yellow appearance with haemorrhagic areas

Answer 32

Clear Cell Renal Cell Carcinoma

Question 33

How does clear cell look on histology?

Answer 33

Lots of clear cells (they're literally clear)

Question 34

Papillary adenoma vs Papillary Renal Cell Carcinoma in terms of size

Answer 34

Adenoma = \<15 mm Carcinoma = \>15 mm

Question 35

fragile, friable brown tumour - which kidney tumour?

Answer 35

Papillary Renal Cell Carcinoma

Question 36

well-circumscribed solid brown tumour - which kidney tumour?

Answer 36

Chromophobe Renal Cell Carcinoma

Question 37

Risk progressoin index used for Renal Cell Carcinoma

Answer 37

Leibovich Risk Model

Question 38

How do UROTHELIAL CARCINOMAS (used to be called transitional cell carcinomas) present?

Answer 38

Haematuria

Question 39

frond-like (leaf-like) growths - which renal tumour?

Answer 39

Non-Invasive Papillary Urothelial Carcinoma

Question 40

Most common malignant tumour in M

Answer 40

Prostatic Adenocarcinoma (this is the malignant form of prostate tumours)

Question 41

Testicular Germ Cell Tumours arise from what?

Answer 41

germ cell neoplasia in situ

Question 42

Malignant type of Testicular Germ Cell Tumours

Answer 42

Post-Pubertal Teratoma