Renal Neoplasms - Handorf Flashcards Preview

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Flashcards in Renal Neoplasms - Handorf Deck (22)

What are common renal neoplasms in adults?

clear cell carcinoma (70)
pipillary carcinoma (10)
chromophobe carcinoma (5)
oncocytoma (5)
angiomyolipoma (1)


What is an angiomyolipoma?

a benign mesenchymal tumor composed of avriable proportions of adipose tissue, spindle and epitheliod smooth muscle cells, and abnormal thick-walled blood vessels. Its often seen in patients with tuberous sclerosis.


What is an oncocytoma?

a gneign renal epithelial neoplasm composed of large cells with mitochondria-rich eosinophilic cytoplasma (why they look granular and basophilic)
Grossly mahogany brown with central stellate scare *30%


on histo exam. what do you seem in an oncocytoma?

stippling (sandy appearance), see nucleoli, no mitotic figures (but not exclusive to oncocytomas)


When renal carcinomas are spread hematogenously, what organs should we be concerned about?

lung, bone brain skin,


when renal carcinomas are spread lymphatically, what should we be concerned about?

renal hilar nodes
para-aortic nodes
cervical node s(rare)


what is the presentation for renal carcinoma?

hematuria in 50ish yo man presenting with dull flank pain (worsens on pressure).


what is the specific renal tumor that palpating is crucial in dx?

wilms tumor


what is clear cell carcinoma

malignant neoplasm composed of cells with clear or eosinophilic cytoplasm within a delicate vascular network. usually solitary , polar, and yllow (often fatty), with cysts, necrosis and hemorrhage


what is the chromosome abnormality for clear cell carcinoma that is genetic?

chromosome 3p deletion in sporadic and familial (von hippel lindau)


what are the three questions you want to ask to differentiate between cancers?

polar or peripheral
what color
cystic or not


describe the nuclei in clear cell carcinoma

you can't, their description is being extremely bland.


what is the difference between low and high nuclear grade in clear cell carcinoma?

high nuclear grade has a lot of nuclear ability


what are common genetic mutations that lead to clear cell carcinoma?

translocations 3:6, 3:8 or 3:11
deletions on chromosome 3 basically
or hypermethylation of VHL


What is the relationship between clear cell carcinomas and veins?

they love to invade veins, not into the structure of them but growing through. Can invade all the way into the right heart which is why you can get frequent lung metastases


What is a papillar carcinoma?

a malignant renal parenchymal tumor with a papillary or tubulopapillary architecture, bilateral and multifocal tumors are more common. no standard cytogenetic characteristics except 7q variant.


When you have dialysis, by how much does your risk of renal cancer increase?

50 fold (60% clear cell, 40% papillar)


on histology, what do papillary carcinomas look like?

they have finger-like projections


what are the genetics assocaited with papillary carinoma?

trisomy 7, 16, 17
loss of y
activated MET


what is chromophobe carcinoma?

characterized by large pale cells with prominent cell membranes, no specific genetic signature, lower mortality, polar, some have clear cells


when is the most important risk factor for renal cancer?

smoking (15-20% of smokers have cancer. 100% are pre-cancerous


What is wilms tumor?

pediatric tumor of kidney, rarely in adults. 90% survival rate. composed of a mixture of cellular elements