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Lecture 7

Urinary Tract Neoplasm

If you see a word refering to a disease and it ends in -oma what do you know about that disease it implies that the disease is benign
What renal tumor is grossly brown-orange and sometimes has a central scar Renal oncocytoma
This tumor is small (<.5cm) well circumscribed, pale, and found in the middle of the medullary pyramids Medullary fibroma
How is an angiomyolipoma diagnosed on imaging
Why don't we resect every angiomyolipoma risk of hemorrhage
What tumor is grossly yellow with areas of hemorrhage (benign) Angiomyolipoma
Angiomyolipoma is difficult to distinguish from? renal cell carcinoma of the clear cell type
What is an angiomyolipoma composed of microscopically adipose tissue, smooth muscle and thick walled vessels
Angiomyolipomas ave a strong association with? Tuberous sclerosis (80% of patients with TS have angiomyolipomas)
When is mesoblastic nephroma usually picked up? in 1st 3 months of life
what benign tumor is grossly not very distinct and quite variable in size (1cm to >15cm) Mesoblastic Nephroma
What tumor is microscopically composed of fusiform cells differentiating towards fibroblast or myofibroblasts Mesoblastic Nephroma
Nephroblastoma (not benign) is also referred to as? Wilms Tumor
What are the 3 embryonal elements the compose a wilms tumor Blastema, Stroma, epithelial
When and how does Wilms tumor present large abdominal mass from 1-3 years of age
Wilms tumor is very uncommon after what age 10
What is the gross appearance and microscopic composition of a Wilms tumor pale tan on cut surface and microscopically usually a mixture of the 3 embryonal elements
what are the congenital syndromes associated with the 5% of Wilms tumors that are not sporadic WAGR syndrome, Denys-Drash syndrome, or Beckwith-Wiedeman syndrome
what gene is responsible for all wilms tumors in the context of WAGR syndrom and 10% of sporadic Wilms Tumors WT1 tumor suppressor gene
what is the most common malignant renal cell tumor in adults Renal Cell Carcinoma (>11,000 cases / year)
about 1/3 of renal cell carcinomas are associated with? tobacco use
what are the syndromes/diseases associated with 5% of inherited Renal Cell Carcinomas AD renal cell carcinoma syndrome, von Hippel-Lindau disease, hereditary papllary reanl cell carcinoma syndrome
Loss of 1 allele of what gene on what chromosome is responsible for the vast majority of sporadic conventional (clear cell) renal cell carcinomas Loss of one allele of the VHL gene on chromosome 3p
what are the 4 main types of renal cell carcinoma Conventional (clear cell), Papillary, Chromophobe, and Collecting duct carcinoma
Prognosis of Clear cell (conventional) renal cell carcinoma is based on? stage and grade
Does papillary renal cell carcinoma have a better or worse prognosis than Conventional clear cell renal carcinoma for the most part better
What renal cell carcinoma stains a gorgeous turquoise color with Hale's colloid iron? Chromophobe renal cell carcinoma
What renal cell carcinoma has a hobnail configuration in a dense stroma Collecting duct carcinoma
what is the most common (70%) renal cell carcinoma Conventional (Clear cell) type
where do Urothelial (transitional cell) carcinomas arise in the urothlium of the renal pelvis (morphologically identical to the urothelial carcinomas of the bladder)
Created by: UVAPATH3