Tumors of the Kidney & Urinary Tract

Question 1

How does a clear cell carcinoma appear grossly?

Answer 1

a single, spherical, yellow-gray mass with focal hemorrhages

Question 1

Most common cytogenetic abnormalities in papillary carcinoma are ______.

Answer 1

• trisomies 7, 16, and 17
• loss of Y

Question 2

What is the most rare benign tumor of the kidney?

Answer 2

metanephric adenoma

Question 3

The VHL gene encodes a protein that is part of a _______ complex involved in targeting other proteins for degradation.

Answer 3

ubiquitin ligase

Question 3

What is the prognosis for Collecting Duct (Bellini duct) Carcinoma?

Answer 3

poor

Question 4

This benign tumor of the kidney consists of vessels, smooth muscles, and fat.

Answer 4

angiomyolipoma

Question 5

What does RCC stand for?

Answer 5

renal cell carcinoma

Question 6

What is the prognosis for Chromophobe Renal Carcinoma?

Answer 6

excellent

Question 7

Current studies implicate the _____ gene in the development of both familial and sporadic clear cell tumors.

Answer 7

VHL (Von Hippel-Lindau)

Question 7

Where does chromophobe renal carcinoma grow from?

Answer 7

intercalated cells of collecting ducts

Question 7

What does TCC stand for?

Answer 7

transitional cell neoplasm

Question 8

What tumors comprise Von Hippel-Lindau (VHL) syndrome?

Answer 8

• hemangioblastomas of the cerebellum
• retina renal cysts
• bilateral RCCs

Question 9

How is RCC further categorized?

Answer 9

• clear cells, granular cells, or a mixture
• Fuhrman’s Criteria = 1-4, with higher # being worse
• Spindle cell types or sarcomas spread most quickly

Question 9

The average 5-year survival rate of patients with renal cell carcinoma is about ____%.

Answer 9

45

Question 11

A tumor of the kidney consisting of EOs and epi cells with numerous mitochondria is called?

Answer 11

an oncocytoma

Question 12

Where does RCC arise from?

Answer 12

the renal epithelium

Question 13

What is the most common tumor of the urinary tract?

Answer 13

transitional cell neoplasms (TCC)

Question 14

Where does renal fibroma/hamartoma occur?

Answer 14

in the pyramids

Question 15

Clear CC more often occurs in males or females?

Answer 15

males

Question 16

Where does Collecting Duct (Bellini duct) Carcinoma arise from?

Answer 16

from collecting duct cells in the medulla

Question 17

Who gets transitional cell neoplasms of the urinary tract?

Answer 17

• 50 -80 year olds
• Males
• pts from urban areas
• smokers
• pts exposed to acrylamide (2-snaphthylamine)
• Hx of Schistosoma haematobium infections in Egypt and Sudan
• Pts exposed to radiation

Question 18

What do oncocytomas consist of?

Answer 18

• EOs
• epi cells with numerous mitochondria

Question 19

What makes up an angiomyolipoma?

Answer 19

• vessels
• smooth muscles
• fat

Question 20

Where does renal papillary adenoma occur?

Answer 20

in the cortex

Question 21

Unlike clear cell RCCs, ______ are frequently multifocal.

Answer 21

papillary carcinomas

Question 23

What is the most common malignant tumor of the kidney?

Answer 23

renal cell carcinoma (RCC)

Question 23

About 95% of urinary tract tumors are of ______ origin, the remainder being ______ tumors.

Answer 23

epithelial; mesenchymal

Question 24

Most common cytogenetic abnormalities in ______ are trisomies 7, 16, and 17 and loss of Y.

Answer 24

papillary carcinoma

Question 25

\_\_\_\_\_\_ tend to grow and spread more quickly than the other kinds of RCCs and thereby have a poor prognosis.

Answer 25

Spindle cell types or sarcomas

Question 27

Where is the VHL (Von Hippel-Lindau) gene located?

Answer 27

short arm of chromosome 3

Question 28

What is the median survival time for a pt with metastatic kidney cancer?

Answer 28

13 months

Question 29

Are most cases of RCC sporadic or genetic?

Answer 29

sporadic

Question 31

What is the 2nd most common malignant tumor of the kidney, and who gets it?

Answer 31

Wilms tumor; children

Question 33

What does renal papillary adenoma look like?

Answer 33

small, well circumscribed nodules within the cortex

Question 34

What is the tx for RCC?

Answer 34

nephrectomy or partial nephrectomy

Question 35

How does clear CC look on imaging?

Answer 35

* a ball-like mass of renal cortex * usually a single tumor

Question 36

Dx? * Cells with prominent cell membranes and pale eosinophilic cytoplasm * usually with a halo around the nucleus

Answer 36

Chromophobe Renal Carcinoma

Question 37

Where does transitional cell neoplasm (TCC) metastasize to?

Answer 37

* lungs * bones * liver

Question 38

How does a pt with transitional cell neoplasm (TCC) clinically present?

Answer 38

* hematuria * irritative bladder symptoms such as dysuria, urinary frequency, and urgency

Question 40

Where does clear cell carcinoma most often metastasize?

Answer 40

* renal vein * IVC * heart * lungs

Question 41

Which benign tumor is always surgically removed bc it's considered "early cancer?"

Answer 41

renal papillary adenoma

Question 42

Describe the histological appearance of Chromophobe Renal Carcinoma.

Answer 42

* Cells with prominent cell membranes and pale eosinophilic cytoplasm * usually with a halo around the nucleus