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Repro / GU > SM_233b: Renal and Urothelial Pathology and Cancer > Flashcards

SM_233b: Renal and Urothelial Pathology and Cancer Flashcards

1
Q

Describe a normal kidney

A

Kidney

  • Cortex: glomeruli, proximal tubules, distal tubules
  • Medulla: loops of Henle, collecting ducts, renal pelvis and calyces
  • Other components: vessels, connective tissue
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2
Q

This is a ___

A

This is a renal calyx

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3
Q

Describe common renal tumors

A

Renal tumors

  • Benign: oncocytoma, papillary adenoma, angiomyolipoma
  • Malignant: clear cell renal cell carcinoma (most cell), papillary renal cell carcinoma, chromophobe renal cell carcinoma, other tumors
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4
Q

Describe renal oncocytoma

A

Renal oncocytoma

  • Benign
  • Eosinophilic cytoplasm (mitochondria)
  • May have nuclear atypia
  • May involve capsule and perinephric fat but still benign
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5
Q

Describe angiomyolipoma

A

Angiomyolipoma

  • Mostly benign tumor composed of vessels, smooth muscles (perivascular epithelial cells), and fat
  • Characteristic appearance on radiology but variants
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6
Q

Papillary adenoma is ____ and ____

A

Papillary adenoma is < 1.5 cm in size and low nuclear grade

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7
Q

Describe renal carcinomas

A

Renal carcinomas

  • Clear cell RCCs have clear cells
  • Papillary RCCs have papillae
  • Chromophobe RCCs have cells that fear color
  • High grade tumors may develop sarcomatoid features
  • RCCs with sarcomatoid features have cells that look like spindle cell sarcoma
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8
Q

This is ____

A

This is low grade clear cell renal cell carcinoma

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9
Q

This is ____

A

This is high grade renal cell carcinoma

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10
Q

Describe Fuhrman grading of clear cell renal cell carcinoma

A

Fuhrman grading of clear cell renal cell carcinoma

  • G1: nucleoli not seen
  • G2: nucleoli at high power
  • G3: nucleoli at low power
  • G4: bizarre nuclei
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11
Q

Describe papillary renal cell carcinoma

A

Papillary renal cell carcinoma

  • Type 1 and Type 2
  • High nuclea grade and low nuclear grade
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12
Q

This is ___

A

This is papillary renal cell carcinoma type 1

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13
Q

This is ___

A

This is papillary renal cell carcinoma type 2

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14
Q

This is ___

A

This is papillary renal cell carcinoma mixed type

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15
Q

This is ____

A

This is chromophobe renal cell carcinoma

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16
Q

Describe translocation renal cell carcinoma

A

Translocation renal cell carcinoma

  • Xp11-associated
  • Partners: TFE3 (less rare), TFEB (more rare)
  • Very rare
  • Poor prognosis: rapidly growing so high stage at discovery, does not respond to conventional clear cell RCC chemo, few trials
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17
Q

This is ____

A

This is bladder

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18
Q

Bladder consists of ____, ____, and ____

A

Bladder consists of umbrella cells at the top, basal cells at the bottom, and basement membrane attached to the lamina propria

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19
Q

This is ___

A

This is bladder muscle

20
Q

Cystitis can be ____ or ____

A

Cystitis can be infectious or non-infectious

  • Infectious: BCG, parasite, bacterial, malakoplakia (generally due to chronic E. coli combined with phagocytic defect)
  • Non-infectious: interstitial, polypoid, hemorrhagic (cytotoxic agent such as cyclophosphamide)
21
Q

Describe chronic cystitis and follicular cystitis

A

Chronic cystitis and follicular cystitis

  • Gram negative bacteria (E. coli)
  • Lymphocytic infiltrate (chronic cystitis)
  • When long-standing: formation of follicles with germinal centers (follicular cystitis)
  • Type of bacteria cannot be determined histologically
22
Q

This is ____

A

This is Schistosoma cystitis and malakoplakia

23
Q

Describe BCG cystitis

A

BCG cystitis

  • BCG used as treatment of bladder cancer, particularly CIS
  • Induces granulomatous inflammation (similar to TB)
  • Immunotherapy
24
Q

This is ___

A

This is cystitis glandularis and cystitis cystica

25
Q

Describe the pathologic classification of bladder carcinoma

A

Pathologic classification of bladder carcinoma

  • Urothelial carcinoma: flat (carcinoma in situ, invasive), papillary (non-invasive, invasive)
  • Other primary bladder cancers: squamous cell carcinoma, adenocarcinoma, small cell carcinoma, carcinosarcoma, melanoma
26
Q

These are ___

A

These are flat urothelial lesions

27
Q

These are ___

A

These are papillary lesions

28
Q

Describe WHO classification of urothelial neoplasms

A

WHO classification of urothelial neoplasms

  • Papilloma
  • Papillary urothelial neoplasia of low malignant potential
  • Low grade papillary urothelial carcinoma
  • High grade papillary urothelial carcinoma
29
Q

This is ___

A

This is urothelial papilloma

30
Q

This is ___

A

This is low grade papillary urothelial carcinoma

31
Q

This is ___

A

This is papillary urothelial neoplasm of low malignant potential

32
Q

This is ___

A

This is high grade papillary urothelial carcinoma

33
Q

Describe urothelial carcinoma

A

Urothelial carcinoma

  • Derived from urothelium
  • May occur in any part of urinary tract including renal pelvis, ureter, bladder, and urethra
  • Most common site is bladder
  • Upper urinary tract urothelial carcinoma tends to be more aggressive and more likely to spread to low urinary tract
34
Q

Major risk factors for urothelial carcinoma are ____ and ____ and also ____ in Egypt

A

Major risk factors for urothelial carcinoma are smoking and pollution and also Schistosoma infection in Egypt

35
Q

Describe urothelial CIS (high grade dysplasia, severe dysplasia)

A

Urothelial CIS (high grade dysplasia, severe dysplasia)

  • All high nuclear grade: positive urine cytology
  • Aggressive disease: may develop into invasive high grade carcinoma in weeks or months without treatment
36
Q

Ureter is ___ with ___

A

Ureter is a thin urine conducting tube with muscularis propria

37
Q

This is ___

A

This is high grade papillary urothelial carcinoma

38
Q

This is ___

A

This is urothelial carcinoma in situ

39
Q

This is ___

A

This is urothelial carcinoma with pagetoid spread

40
Q

Describe low grade papillary urothelial carcinoma

A

Low grade papillary urothelial carcinoma

  • Most common type of bladder cancer
  • Papillary growth
  • Tumor cells with fibrovascular cores
  • Only < 10% invasive
  • Often recur
41
Q

Describe high grade papillary urothelial carcinoma staging

A

Hgh grade papillary urothelial carcinoma staging

  • No invasion
  • Lamina propria invasion / suspicious for invasion
  • Muscularis propria invasion
  • Extravesical invasion
42
Q

This is ___

A

This is sarcomatoid urothelial carcinoma

43
Q

This is ___

A

This is micropapillary urothelial carcinoma

44
Q

Adenocarcinoma of the bladder is ___

A

Adenocarcinoma of the bladder is composed entirely of malignant glandular epithelial cells

45
Q

Urothelial carcinoma with glandular differentiation is ___

A

Urothelial carcinoma with glandular differentiation is presence of both urothelial carcinomas and malignant glandular components

46
Q

This is ___

A

This is secondary involvement (metastasis)

47
Q

This is ___

A

This is primary small cell carcinoma

Repro / GU (46 decks)

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