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23 Cards in this Set

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Name 3 benign and 2 malignant tumours of the kidney along with cell of origin
Benign: adenoma (tubular epithelial cells), oncocytoma (intercalated cells of collecting duct), angiomyolipoma
Malignant: adenocarcinoma (renal tubular epithelium), urothelial carcinoma of the pelvis (urothelial cells)
Papillary adenoma: cell origin and location, configuration, size
1. Cell origin and location: renal tubular epithelium in cortex
2. Configuration: papillary (most)
3. Size: <5cm
Angiomyolipoma: composition, common association, clinical significance
1. Composition: blood vessels, smooth muscle, fat
2. Common association: tuberous sclerosis
3. Clinical significance: tendency to bleed
Oncomyocytoma: Origin, etiology, gross appearance, size, microscopic appearance
1. Origin: intercalated cells of collecting ducts
2. Etiology: sporadic (most), familial
3. Gross appearance: tan mohogany brown, well-encapsulated
4. Size: up to 12cm
5. Microscopic appearance: large eosiniphillic cells
Adenocarcinoma: Epidemiology, Risk Factors, Classification, Genetic Forms
1. Epidemiology: 85% of renal malignancies, 60-70's, males>females
2. Risk Factors: smoking, heavy metals, chronic renal failure, acquired cystic disease, obesity, HTN, unopposed estrogen therapy, asbestos, petroleum products, tuberous sclerosis
3. Types: clear cell (70-80%), papillary (10-15%), chromophobe (5%), collecting duct carcinoma (1%), translocation carcinoma (rare)
4. Genetic Forms: Von Hippel-Lindau syndrome, mutation in VHL gene with only kidneys affected, mutations of MET proto-onco genes (autosomal dominant, bilateral papillary RCC)
Clear Cell Renal Cell Carcinoma: Etiology, Origin, Gross morphology, Microscopic morphology, Grading
1. Etiology: sporadic (95%) or familial (5%), solitary, unilateral, associated with VHL mutation
2. Origin: proximal renal tubule
3. Gross morphology: well-demarcated, golden yellow
4. Microscopic morphology: Clear cells surrounded by delicate vessels
5. Grading: Furhman nuclear grades 1-4
Papillary Renal Cell Carcinoma: Precursor, Etiology, Microscopic appearance
1. Precursor: papillary adenoma
2. Etiology: familial (trisomy 7 MET gene) and sporadic (trisomy 7,16,17, loss of Y)
3. Microscopic appearance: Papillary configuration, fibrovascular cores, foamy macrophages, psammoma bodies
Chromophobe Renal Cell Carcinoma: Origin, Prognosis, Etiology, Gross morphology, Microscopic morphology
1. Origin: Intercalated cells of collecting duct
2. Prognosis: better than clear cell and papillary
3. Gross morphology: mahogany with central scar
4. Microscopic morphology: sheets of cells, eosinophilic, thic cell membrane, rasinoid nuclei with perinuclear halo
Collecting Duct Carcinoma: Origin, Microscopic appearance, Prognosis
1. Origin: epithelium of collecting ducts in medulla of kidney
2. Microscopic appearance: malignant cells in densely fibrotic stroma
3. Prognosis: poor
Urothelial Carcinoma of Renal Pelvis: Size, Association, Microscopic appearance
1. Size: small at presentation b/c cause hematuria
2. Association: bladder tumour
3. Microscopic appearance: identical to bladder tumour
Name 5 types of urinary bladder tumours
1. Urothelial tumors: papillary, flat, invasive
2. Squamous neoplasms
3. Glandular neoplasms
4. Neuroendocrine tumours
5. Mesenchymal tumours
Urothelial Lesions: Types + Grades + histology
1. Papillary: Hyperplasia; Neoplasms - Urothelial Papilloma (benign, fibrovascular cores covered with normal urothelium), papillary urothelial tumor of low malignant potential (thicker urothelium +/- mitoses), Low Grade Papillary Urothelial Carcinoma (thicker urothelium, enlarged nuclei, mitotic figures), High Grade Papillary Urothelial Carcinoma (thick urothelium, enlarged/crowded nuclei, nuclear atypia, mitoses)
2. Flat lesions: Normal, Hyperplasia, Flat Lesions with Atypia [reactive, dysplasia (low grade), carcinoma in situ (high grade)]
3. Invasive Urothelial Carcinoma: associated with high grade papillary urothelial carcinoma or flat CIS, degree of invasion into bladder impt for prognosis, variants (nested, micropapillary, lymphoepithelioma like)
Testis Tumours Classification
1. Germ Cell tumours: Seminomatous (seminoma, spermatocytic seminoma)
Non-seminomatous (embryonal carcinoma, yolk sac tumor, teratoma, choriocarcinoma), Mixed
2. Sex Cord Stromal Tumours: Leydig Cell, Sertoli Cell
Germ Cell Tumours: Epidemiology, Etiology, Types
1. Epidemiology: 95% of testicular tumours
2. Etiology: Genetic (associated with testicular dysgenesis syndrome), Environmental
3. Types: Seminoma, spermatocytic seminoma, embryonal carcinoma, yolk sac tumour, teratoma, choriocarcinoma, mixed
Seminoma: Epidemiology, Prognosis, Morphology, Histology
1. Epidemiology: 50% of germ cell tumours, peak in 20's
2. Prognosis: aggressive but treatment cures
3. Morphology: uniform, gray/tan with necrosis or hemorrhage
4. Histology: Uniform sheets, lymphocytes, large central nucleus, syncytiotrophoblasts, granulomas
Spermatocytic Seminoma: Epidemiology, Immunohistochemistry, Prognosis
1. Epidemiology: Less common than seminoma, over 65, slow growing
2. Immunohistochemistry: PLAP negative
3. Prognosis: excellent
Embryonal Carcinoma: Epidemiology, Morphology, Histology
1. Epidemiology: 20-30s, aggressive
2. Morphology: necorsis and hemorrhage, extension through tunica albuginea into epididymis or spermatic cord
3. Histology: alveolar or tubular pattern
Yolk Sac Tumour: Epidemiology, Prognosis, Morphology, Histology
1. Epidemiology: most common testicular tumour in children <3, rare in adults
2. Prognosis: good
3. Morphology: Non-encapsulated, white-yellow, mucinous
4. Histology: reticular network of flattened or cuboidal cells, Schiller-Duval bodies, hyaline bodies (positive for AFP and antitrypsin)
Choriocarcinoma: Epidemiology, Morphology, Histology, Immunohistochemistry
1. Epidemiology: highly malignant, rare in pure form
2. Morphology: small palpable nodules, very hemorrhagic
3. Histology: mix of syncitio and cytotrophoblastic cells
4. Immunohistochemistry: Positive for HCG
Teratoma: Epidemiology, Morphology, Histology
1. Epidiomology: Occur at any age but more common in infants, less common in pure form
2. Morphology: Heterogenous mix of different germ layer tissues
3. Histology: normal cells from various tissues, can become atypical
Mixed Germ Cell Tumours: Epidemiology, Common Combinations
1. Epidemiology: 65-75% of germ line tumours
2. Combinations: Teratoma+embryonal carcinoma+yolk sac tumour, seminoma+embryonal carcinoma, embryonal carcinoma+teratoma
Leydig Cell Tumours: Epidemiology, Secretions, Clinical Presentation, Morphology, Histology, Benign or Malignant
1. Epidemiology: any age
2. Secretions: androgens, estrogens, corticosteroids
3. Morphology: well circumscribed, <5cm, golden brown
4. Histology: Similar to normal cells but contain rod shaped Reinke crystals
5. Benign or Malignant: most benign
Sertoli Cell Tumours: Benign or Malignant, Secretions, Morphology, Histology
1. Benign or Malignant: Most benign, 10% malignant
2. Secretions: hormonally silent
3. Morphology: small, firm nodules, homogenous ray-white-yellow
4. Histology: distinctive trabeculae that form cord-like structures and tubules