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Flashcards in Renal Deck (37)
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31

Compare urothelial carcinoma of the renal pelvis and renal cell carcinoma.

Urothelial carcinoma = renal pelvis

resemble transitional carcinoma

 

RCC = most common kidney cancer

possibly caused by smoking, link with VHL syndrome (loss of VHL tumor suppressor gene, characterized by appearance of cerebellar hemangioblastomas and retinal angiomas)

- sharply demarcted nodules and masses

- cuboidal cells

- "clear cell carcinoma"

32

How common is carcinoma of the urinary bladder?

= most common urinary tract cancer

3x more common in males

 

33

Correlate the macroscopic and microscopic features of urinary bladder carcinoma with the clinical features of this tumor.

May be papillary or flat. Papillary = wartlike, flat = mucosal thickenings. Either may be invasive or noninvasive. 

Papillary 

low or high grade:

- low = lined by uniform cells

- high = mitotic, pleomorphic, hyperchromatic

Flat

carcinoma in situ or invasive

- anaplastic, resemblance to urethelial mucosa

Squamous/adeno

preceded by squamous/glandular metaplasia

sarcomas

from smooth muscular bladder wall

  1. flat high-grade malignancy, carcinoma in situ
  2. papillary tumor confined to urothelium (Ta)
  3. papillary tumor invading lamina propria (T1)
  4. papillary and invasive tumor involving muscle (T2)
  5. invasive tumor extending through perivesical fat (T3)

34

What are the typical symptoms of urinary bladder carcinoma?

clinical: hematuria, dysuria, low abd pain

35

What is the outcome of treatment of urinary bladder carcinoma?

Treatment: surgical resection, chemo
also immunotherapy (intravesical, BCG)

 

low grade tumors tend to recur

Stage 1 low grade, no invasion = 95% 10 yr survival

Invasion of muscle layer = 25% mortality

36

Clinical features of acute glomerulonephritis

Damaged basement membranes of the inflamed glomeruli become permeable >> proteinuria + hematuria

decreased GFR >> oliguria

loss of protein >> edema

reduced blood flow lead to inflamed glomeruli, release of renin >> HTN

37

Goodpasture's syndrome

Autoimmune disease characterized by formation of antibodies to the body's own basement membrane component:  collagen type IV

Causes intralveolar hemorrhage + ruptured glomerular basement membranes

macrophages exit through the holes in the BM, accumultate in the urinary space >> crescents that compress the capillary loops = anuria

rapidly progressive glomeruonephritis