Hydronephrosis

Question 1

key to detemining TNM staging

Answer 1

whether muscularis propria invaded

Question 2

most common benign tumor of kidney

most common complication of this tumor

Answer 2

angiomyolipoma (mesenchymal tumor)

hemorrhage complication

Question 2

polypoid cystitis morphology

Answer 2

projections blunt/broad based,

best diagnosed at low power

Question 2

grading of urothelial grading based on

Answer 2

nuclei arrangemen/polarity and invasion

Question 3

61% of neprhogenic adenoma (nephrogenic metaplasia) arise following

Answer 3

GU surgery

Question 4

associations medullary carcinoma

Answer 4

african or mediterranean descent

patients have sickle cell or sickle cell trait

worst outcome of all kidney cancers (1-7months)

Question 4

morphology nephrogenic adenoma

Answer 4

benign proliferation of tubules, inflammatory cells

Question 5

angiomyolipoma derived from

Answer 5

cell type with premelanosomes > stains positive with melanoma markers

Question 5

papillary cystitis morphology

Answer 5

lined by urothelium

stroma has inflamm cells

Question 6

patients with acquired cystic diseasse due to crhonic dialysis dependency have a 100x risk of

Answer 6

oxalate crystals

Question 6

association, morphology Celar Cell tubulopapillary carcinoma

Answer 6

occurs in ESkidneys (cystic or non-cystic)

papillary cores lined by cells with clear cytoplasm and clei towards lumen apical surface

tight packed tubules

Question 8

morphology clear cell type renal carcinoma

Answer 8

softening center of tumor = gelatinous necrosis (worsens outcome)

Question 9

association upper urothelial tract orothelail carcinoma

Answer 9

mismatch repaire genes (as in Lynch syndrome)

instabilitity of at least two microstellite markers

Question 11

presentation renal cell carcinoma

Answer 11

painless hematuria

palpable abdominal mass

dull flank pain

polycythemia in 10% due to EPO production by tumor (paraneoplastic syndrome)

Question 12

morphology papillary type renal cell carcinoma (2 types)

Answer 12

tumor cells line finger like projection into stroma

prominent nuclei

blood vessess + macrophages

papilalry type 1 - thin papillae, small cuboidal

paillary type 2 - thick papilae, abundeant cytoplasma

Question 13

differentiate pT1 vs pT2

Answer 13

muscularis propria involvement

Question 14

morphology chromophobe carcinoma

Answer 14

normal glomerulus

circumscribed tumor

halo around wrinkled nuclei

binucleateed cells

metatasis rare

Question 15

features of exophytic or papillary carcinoma to report on TURBT

Answer 15

invasive? (into lamina propria)

muscularis propria present?

precent involvement

necrosis

Question 16

oncocytoma arises from

Answer 16

intercalated cells of colelctin duct

Question 18

morphology collecting duct carcinoma

Answer 18

irregular aggregates of tumor cells

surrounded by endemetous desmoplastic stroma

large 6-11cm

metatasize early

Question 19

morphology oncocytoma

Answer 19

gross - yellow brown with central scarring

LM - edematous stroma (white)

nests/islands of pink eosinophilic cytoplasm

Question 20

renal cell carcinoma stagin

Answer 20

T1 -

T2 >7cm, confined to kidney

T3a - extend to fat of kidney capsule

T3b - extend to renal vein, pos to IVC

Question 22

morphology angiomyolipoma

Answer 22

prominent vessels

muscle cells

bubbly vacuolated cells

Question 23

common histo finding of carcinoma in situ due to distburbed cell-cell interaction

Answer 23

denuding cystitis - dicohesive cells

Question 24

polypoid cystitis vs papillary cystitis

Answer 24

both arise with submucosal edema, inflammation polypoid cystitis has more blunt projections, tip wider than base than papillary, which is more likely to mimc tumor

Question 25

morphology hydronephrosis

Answer 25

cortex and medulla compressed to a rim pelvicalyceal system dilated

Question 26

morphology urothelial papilloma

Answer 26

minially branching delicate papillae with fibrobascualr core lined with normal urothelium, no significant cytologic atypia

Question 27

\_\_\_% with carcinoma in situ develop biopsy proven cancer often presents with bladder ulcerations mimicking some benign conditions

Answer 27

60%

Question 28

common staging of upper urothelial tract urothelial carcinoma

Answer 28

most are high grade and locally advanced (agressive, muscle wall is thin)

Question 29

stages of TNM with no muscularis propria invasia

Answer 29

pTIS, pTa Pt1

Question 30

morphology medullary carcinoma

Answer 30

atpyical cells with prominetn nuclei subtle borders necrosis as tumor outgrows blood supply

Question 31

renal cell carcinoma nucleolar grading

Answer 31

Grade 1 - tiny dot nuclei Grade 2 - nuclei variation, nucleoli inconspicuous grade 3 nuclei appreciated at low power grade 4 - bizarre cells

Question 32

flat intra urothelial neoplasia morphology

Answer 32

loss of polarity nuclear clustering increased nuclear size nuclear peoplmorphism increased chromatin granularity scattered nucleoli

Question 33

wilms tumor components derived from

Answer 33

mesoderm

Question 35

morphology cystitis cystica / glanularis

Answer 35

nest of cells mucin developing cells \> inflammation (PMNs)

Question 36

risk of ancer in urothelial dysplasia

Answer 36

mildly increased (15%)