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Renal Neoplasms Flashcards

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1
Q

What are the gross Characteristics of adenoma

A

Pale yellow gray well circumcised nodules

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2
Q

Describe the histologic characteristics of adenoma

A

Peppa lemada structures with numerous complex fronds; cells are cubodial to polygonal With small central nuclei with little cytoplasm

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3
Q

We’re in the kidneys papillary adenoma Commonly found

A

Renal cortex

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4
Q

Adenoma is derived from what part of the kidney

A

renal tubular epithelium

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5
Q

Angiomyolipoma is derived from what renal structure

A

perivascular epithelioid cells

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6
Q

Angiogmyelipomas are commonly found in which population and why

A

women; These cells express estrogen receptors

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7
Q

Additionally angiomyolipomas are associated with what disease

A

tuberous sclerosis

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8
Q

Describe the pathogenesis of tuberous sclerosis

A

Inhibition of activity of mTOR, kinase that stimulates cells growth TSC1 (Ch. 9, hamartin); TSC2 (Ch. 16, tuberin);

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9
Q

What’s the contents found in angiomyolipoma lesions

A

Thick walled blood cells, adipose tissue, and smooth muscle cells

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10
Q

Oncocytoma arises from What cells in the kidneys

A

intercolated cells of the collecting ducks

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11
Q

Describe the gross characteristics of oncocytoma

A

mahogany brown encapsulated lesions with central scarring

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12
Q

Describe the histologic characteristics of o oncocytoma

A

many mitochondria; granular eosinophilic cytoplasm with uniform around nuclei

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13
Q

What are risk factors for renal cell carcinoma

A

Tobacco use, hypertension, obesity, unopposed estrogen therapy, asbestos, petroleum, and heavy metal exposure

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14
Q

What comorbidities are associated with increased risk for renal cell carcinoma

A

In stage renal disease, DM, cystic kidney disease, and tuberous sclerosis

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15
Q

The most common septype of renal cell carcinoma is clear cell. List the different variants within this subtype

A

Von Hippel-Lindau syndrome; tuberous sclerosis; hereditary papillary carcinoma

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16
Q

What type of inheritance Pattern is associated with all familial forms of renal cell carcinoma

A

Autozone will dominate

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17
Q

Describe the pathogenesis of von Hippel-lindau

A

Overactivation of HIF on VHL gene Located on chromosome 3; promotes angiogenesis, cell growth and some metabolism

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18
Q

List the common clinical manifestations associated with von Hippel-Lindau ccRCC

A

Hemangioblastoma’s of the cerebellum and retina; Pheochromocytoma (adrenal gland tumor)

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19
Q

Describe the pathogenesis of hereditary papillary carcinoma

A

MET Proto oncogene; This gene is involved in many mediated cell processes from growth to differentiation

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20
Q

List the Parineetioplastic syndromes associated with renal cell carcinoma

A

PEAR:
PTH: Hypercalcemia
EPO: polycythemia
ACTH: Cushing syndrome
Renin: hypertension

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21
Q

What is a unique manifestation of perineal plastic syndrome in males

A

left-sided varicocele; Tumor that blocks the left renal vein which drains into the left testicular vein

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22
Q

Clear cell rcc’s originate in what part of the kidney

A

Proximal tubule

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23
Q

Describe the histologic features of clear cell RCC

A

clear cytoplasm; chicken wire pattern of branching basculature; Clear cytoplasm is due to abundance of lipids and glycogen

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24
Q

Carcinomas have a tendency To invade what structure

A

the renal lane; usually unilateral and rarely bilateral

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25
Describe the gross characteristics of CCRCCS
cystic Yellow to gray white lesions with extensive hemorrhaging
26
Describe the different grades of CCR CC
1: Small come around, uniform nuclei That looked like lymphocytes 2: slightly irregular nuclei; seen at 40x power 3: Very irregular nuclei; seen at 10x power 4: Mitosis with bizarre multilobulated pleomorphic cells w/ sacromatoids
27
papillary renal carcinoma is commonly seen in which patients
Patients with dialysis associated cystic disease
28
Describe the gross characteristics of Papillary rcc
Multifocal hemoretic cystic lesions
29
describe the different pathogenesis of capillary rcc
Associated with Trisomies of seven, 16, 17, loss of Y chromosome; Note: MET Proto onto gene located on chromosome 7
30
Capillary rcc Originates from what part of the kidneys
distal convoluted tubules
31
Describe the histologic characteristics of papillary rcc
Foamy macrophages and psammona bondies
32
Describe the histologic characteristics of chromophobe RCC
Pill ears and excitoplasm with a vegetable cell wall appearance And often have a halo found around the nucleus
33
Describe the gross characteristics of chromophobic rcc
Well circumcised globular solid tan brown lesions
34
chromophobe rcc originates from what cells in the kidneys
Intercolated cells
35
Describe the pathogenesis of chromophobe Rcc
Multiple chromosome losses
36
Describe the pathogenesis of XP11 translocation rcc
Translocations of the TFE 3 gene located at Position xp11.2; Over expression of TFE 3 transcription factor
37
XP11 translocation rcc is commonly found in what population of patients
young patients
38
Bellini RCC Originates from what structure in the kidneys
Collecting Ducks In the medulla
39
Logic features ofbellini rcc
nest malignant cells within fibrotic stroma Along with complex duct like tubular cells
40
How are rcc tumors stage with TNM
'T: Primary tumor N: regional lymph nodes M: Distant metastasis
41
Describe the different stages of T and MRCC
T1 less than seven centimeters; T2 greater than seven centimeters; T three extends into major veins and perinephrat tissues; T4 extends beyond gerota's fascia
42
What is the most common primary renal tumor found in pediatric patients
nephoroblastoma; aka Wilms tumor
43
Nephroblastoma is associated with what syndromes
WAGR syndrome; DD syndrome; BW syndrome
44
Describe the pathogenesis of WAGR syndrome
Deletion of 11p13; WT1 gene;
45
List the clinical manifestations of wagr syndrome
aniridia, Genital anomalies, intellectual disabilities
46
what is the pathogenesis of DD syndrome
mutated WT1 gene
47
List the clinical manifestations of DD syndrome
Gonadal dysgenesis; Early onset of Diffuse mesangial sclerosis and renal failure
48
What is the pathogenesis of BW syndrome
Deletion of 11p15
49
List the clinical manifestations of WBS
organomegaly, Macroglossia, hemi Hypertrophy, omphalocele, enlarged urinals
50
What's the clinical manifestations found In pediatric patients with Nephroblastoma
Large abdominal mass, hematuria, hypertension, intestinal obstruction due to read and release; Occasionally With hepatic pulmonary metastasis
51
describe the gross pathology of nephroblastoma
Soft homogeneous mass that is well circumcised with a fibrous pseudocapsule
52
Describe the histologic characteristics of neuroblastoma
Stromal component: Fibrocytic or myxoid w/ Skeleton muscle, adipose tissue, Cartilage, bone differentiation; Additionally epithelial structures and blastema Immature mesenchyme) is also present
53
Nephroblastoma with anaplasia is associated with what mutations
TP53
54
Describe the characteristics of blastemia`
sheets of uniform small blue cells that are densely packed
55
Describe the characteristics of The epithelial structures found a nephroblastoma
poorly differentiated tubular structures
56
describe the characteristics of the Stroma component of nephrolasoma
fibrovascular with fibroblasts and smooth muscle
57
Transitional cell carcinomas are found in what renal structures
The pelvis and callouses To the distal urethra which is covered by transitional epithelium
58
what gene deletion is associated with superficial papillary and non evasive institute lesions of TCC
9P deletion
59
invasive tc's are associated with what gene pathogenesis
17P deletions and P503 MUTATIONS
60
What are the risk factors for tcc
cigarette spoken, exposure to polycyclic aromatic hydrocarbons, aromatic amines, long term analgetic use, radiation, family history
61
Aggressive TCC invasion into the renal parent kinda leads to what problems
Obstruction and dilation of the pelvis and callouses which produces hydro nephrosis
62
describe the histologic characteristics of tcc
pleomorphic nuclei in the epithelium; fibrovascular core surrounded by stratified transitional epithelium
63
List the clinical manifestatins of TS.
assoc. w/ angiofibromas

Nephrology (11 decks)

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