tumors of the kidney and urinary tract

Question 1

renal parenchyma tumors occurs mostly in the

Answer 1

cortex

Question 2

angiomyolipoma

Answer 2

soft tissue surrounding the kidney tumor

Question 3

renal tumors in adults (3)

Answer 3

1. oncocytoma
2. angiomyolipoma
3. renal cell carcinoma: clear cell, papillary and chromphobe

Question 4

renal tumors in children

Answer 4

nephroblastoma- Wilms’ tumor

Question 5

oncocytoma:

• neoplams of the
• tumor composed of
• tumor cells often grow in
• tumor cells present in
• true or false: tumors are small

Answer 5

• benign epithelial neoplams
• tumor composed of oncocytic cells that are eosinophilic and granular cytoplasm
• tumor cells often grow in nest sand cords
• tumor cells present in a myxoid stroma
• false: they can be very large

Question 6

angiomyolipoma

a. benign neoplasm compose of
b. origin from
c. occurs more in
d. association with

Answer 6

a. composed of blood vessels, smooth muscle and adipose tissue
b. origin from perivascular epithelioid cell
c. more common in female
d. association with tuberous sclerosis

Question 7

renal cell carcinoma:

• malignant neoplasm that arise from the
• ____ of malignancies in adults
• peak incidence ______ decade
• most common in

Answer 7

• arises from the epithelium of renal tubules of both cortex and medulla
• 3% malignancies in adults
• peak incidence 6th decade
• more common in men

Question 8

risk factors in RCC (6)

Answer 8

1. von Hippel-Lindau syndrome
2. tuberous sclerosis
3. tobacco use
4. HTN
5. obesity
6. hemodialysis

Question 9

clinical features of RCC:

1. classic triad
2. non-specific symptoms
3. paraneoplastic syndromes
4. occurs in 30% of patients

Answer 9

1. triad: - hematuria - flank pain - flank mass
2. fever, weight loss, fatigue
3. polycythemia, hypercalcemia
4. metastatic disease

Question 10

classification of RCC (3)

Answer 10

1. clear cell- conventional type
2. papillary
3. chromophobe

Question 11

prognosis of RCC

• chromophobe vs clear cell vs papillary
• fuhrman grade
• stage

Answer 11

• survival decreases with chromophobe> papillary> clear cell
• fuhrman grade: 1-4, dependent of nuclear features
• stage: TNM

Question 12

nephroblastoma (wilm’s tumor)

• embryonal neoplasm derived from
• most common in
• 98% occur
• more commin in

Answer 12

• derived from nephrogenic blastema cells
• common in children
• occurs <10 yr of age
• more common in girls

Question 13

syndrome Risk factors in Whilms tumor and %

Answer 13

1. WAGR- 30%
2. Denys-Drash- 90%
3. Beckwith- Wiedemann ?%

Question 14

clinical features in Whilms

Answer 14

1. abdominal mass
2. pain
3. hematuria
4. HTN
5. traumatic rupture

Question 15

prognosis of nephroblastoma (whilms)

1. age
2. stage
3. grade

Answer 15

1. >2 yr worse
2. i- confined to kidney, ii- beyond kidney, iii- residual non-hematogenous tumor in abdomen, iv- hematogenous metastases , v- bilateral tumor
3. grade: nuclear features

Question 16

benign urothelial neoplasia

Answer 16

urothelial papilloma

Question 17

malignant urothelial neoplasia (3)

Answer 17

1. papillary neoplasms
2. urothelial carcinoma in situ
3. invasive urothelial carcinoma

Question 18

what us happening with urothelial papilloma

Answer 18

rare, occurs in the young, usually a single tumor/lesion with normal urohtelium on top of a fibroblastic core

Question 19

tumor carcinoma

1. arises from
2. most frequently in
3. most common in __yr
4. more common in

Answer 19

1. arises from urothelium
2. occurs in bladder
3. 65 yr
4. men

Question 20

risk factors in urothelial carcinoma

Answer 20

1. tobacco smoking
2. occupational exposure to chemicals such as aniline dyes and aromatic amines

Question 21

clinical presentation of urothelial carcinoma

Answer 21

1. hematuria

Question 22

evaluation/managment of urothelial carcinoma

Answer 22

1. urine cytology
2. cystoscopy
3. biopsy/transurethral resection
4. radiologic studies

Question 23

prognosis of urothelial carcinoma

1. type of tumor

Answer 23

1. papillary neoplasm>in-situ carcinoma>invasive carcinoma

Question 24

Answer 24

oncocytoma- tan, well circumscribed, benign

Question 25

Answer 25

nests of tumor cells associated with oncocytoma

Question 26

Answer 26

oncocytoma with many mitochondria and they are granula

Question 27

Answer 27

angiomyolipoma- well circumscribed

Question 28

Answer 28

angiomyolipoma

Question 29

Answer 29

clear cell RCC

Question 30

Answer 30

clear cell RCC- notice the low grade due to the nuclei looking the same and clear cytoplasm

Question 31

Answer 31

clear cell RCC- notice the tubular growth, eosinophilic cytoplasm indicating a high grade tumor

Question 32

Answer 32

papillary RCC

Question 33

Answer 33

papillary- notice the foamy macrophages

Question 34

Answer 34

papillary with fribroblastic core

Question 35

Answer 35

chromophobe RCC notice how well circuscribed and looking like a oncocytoma

Question 36

Answer 36

chromophobe- notice the diffuse sheets with large and small cells with clear and eosinophilic alt. cytoplasm

Question 37

Answer 37

RCC-T1

Question 38

Answer 38

RCC- T2

Question 39

Answer 39

RCC- we see penetration of capsule

Question 40

Answer 40

tumor in renal vein

Question 41

Answer 41

Whilms tumor

Question 42

Answer 42

whilms tumor

Question 43

Answer 43

blastem associated with whilms

Question 44

Answer 44

epithelium and stroma associated with whilms

Question 45

Answer 45

nests of embryonic kidney- perilobar nephroblastomatosis

Question 46

Answer 46

urothelial papilloma

Question 47

Answer 47

papillary urothelial carcinoma

Question 48

Answer 48

high grade papillary urothelial carcinom

Question 49

Answer 49

high grade papillary urothelial carcinoma

Question 50

Answer 50

flat urothelial carcinoma in situ

Question 51

Answer 51

possible carcinoma in situ of the urothelium

Question 52

Answer 52

normal urothelium

Question 53

Answer 53

urothelial carcinoma in-situ