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"
How common is carcinoma of the urinary bladder?
= most common urinary tract cancer
3x more common in males
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.
low or high grade:
- low = lined by uniform cells
- high = mitotic, pleomorphic, hyperchromatic
carcinoma in situ or invasive
- anaplastic, resemblance to urethelial mucosa
preceded by squamous/glandular metaplasia
from smooth muscular bladder wall
- flat high-grade malignancy, carcinoma in situ
- papillary tumor confined to urothelium (Ta)
- papillary tumor invading lamina propria (T1)
- papillary and invasive tumor involving muscle (T2)
- invasive tumor extending through perivesical fat (T3)
What are the typical symptoms of urinary bladder carcinoma?
clinical: hematuria, dysuria, low abd pain
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
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
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