Flashcards in Kidney Deck (379)
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60
Metanephric adenoma: Mutation.
V600E in BRAF.
61
Metanephric adenoma: Behavior.
Benign.
62
The nuclear grading system of Fuhrman.
1: 20 μm, pleomorphic, open or dark chromatin, macronucleolus.
63
Papillary adenoma: Associations (3).
Long-term hemodialysis.
Chronic pyelonephritis.
von Hippel−Lindau syndrome.
64
Papillary adenoma:
A. Size.
B. Histologic architectural patterns (3).
A. Less than 5 mm.
B. Tubular, papillary, or both.
65
Papillary adenoma: Cytology (2).
Bland cuboidal cells.
Nuclei correspond with Fuhrman grades 1 and 2.
66
Papillary adenoma: Other histologic features (2).
Psammomatous calcifications.
Foamy histiocytes.
67
Papillary adenoma: Disqualifying cytologic feature.
Clear cytoplasm.
68
Papillary adenoma: Immunohistochemistry (2,1).
Positive: CK7, AMACR.
Negative: WT-1.
69
Papillary adenoma: Mutations (3).
+7, +17, -Y.
70
Renal oncocytoma: Radiography.
Central scar ("spoke-wheel" appearance).
71
Renal oncocytoma: Histologic patterns (3).
Classic: Well-defined nests of oncocytes.
Tubulocystic: Tubules and cysts contain eosinophilic secretions.
Mixed: Nests and tubules.
72
Renal oncocytoma: "Tolerable" histopathologic anomalies (3).
Occasional smudged nuclei.
Occasional clear cells.
Focal extension into perinephric fat.
73
Renal oncocytoma: Features that are incompatible with the diagnosis (4).
Gross extension into the perinephric fat.
Papillae.
Sarcomatoid or spindle-cell areas.
Atypical mitotic figures.
74
Renal oncocytoma: Immunohistochemistry (4,1),
Positive: CK7, S100, E-cadherin, claudin 8 (cytoplasmic).
Negative: Vimentin.
75
Renal oncocytoma: Special stain.
Negative: Hale's colloidal iron.
76
Renal oncocytoma: Mutation.
t(5;11) in some cases.
77
Renal oncocytoma vs. clear-cell RCC with eosinophilic cytoplasm: Immunohistochemistry (3).
Clear-cell RCC expresses vimentin but neither CK7 nor E-cadherin.
78
Renal oncocytosis: Causes (2).
Sporadic.
Chronic renal failure.
79
Renal oncocytoma: Putative origin.
Intercalated cells of the collecting ducts.
80
Birt-Hogg-Dubé syndrome: Renal tumor.
Combines features of renal oncocytoma and chromophobe RCC.
81
Renal-cell carcinoma, clear-cell type: Classic presentation.
Pain, flank mass, hematuria: Reported in only 10% of patients.
82
Renal-cell carcinoma, clear-cell type: Genes (4).
VHL.
PBRM1.
BAP1.
SETD2.
83
Renal-cell carcinoma, clear-cell type vs. clear-cell papillary renal-cell carcinoma: Immunohistochemistry.
Clear-cell papillary renal-cell carcinoma . . .
− Positive: CK7 and keratin 34βE12.
− Negative: CD10, AMACR.
Both tumors express CA9.
84
Renal-cell carcinoma, clear-cell type vs. adrenocortical carcinoma: Immunohistochemistry (2).
Adrenocortical carcinoma . . .
− Positive: Inhibin, calretinin.
− Negative: EMA, cytokeratins.
85
Clear-cell papillary renal-cell carcinoma: Cytology (2).
Clear cells with low-grade nuclei.
Nuclei are oriented away from the basement membrane and toward the lumen.
86
Renal-cell carcinoma, papillary type: Syndrome, gene, location.
Hereditary papillary RCC syndrome: c-met on chromosome 7q31.
87
Renal-cell carcinoma, papillary type: Gross pathology (2).
Fibrous pseudocapsule.
May be multifocal or bilateral.
88
Renal-cell carcinoma, papillary type, type I: Histopathology.
Papillae are lined by a single layer of cells with low-grade nuclear features and scant cytoplasm.
89
