Pathology Of Kidney, Bladder And Testis

Front 1

Name 3 benign and 2 malignant tumours of the kidney along with cell of origin

Back 1

Benign: adenoma (tubular epithelial cells), oncocytoma (intercalated cells of collecting duct), angiomyolipoma
Malignant: adenocarcinoma (renal tubular epithelium), urothelial carcinoma of the pelvis (urothelial cells)

Front 2

Papillary adenoma: cell origin and location, configuration, size

Back 2

1. Cell origin and location: renal tubular epithelium in cortex
2. Configuration: papillary (most)
3. Size: <5cm

Front 3

Angiomyolipoma: composition, common association, clinical significance

Back 3

1. Composition: blood vessels, smooth muscle, fat
2. Common association: tuberous sclerosis
3. Clinical significance: tendency to bleed

Front 4

Oncomyocytoma: Origin, etiology, gross appearance, size, microscopic appearance

Back 4

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

Front 5

Adenocarcinoma: Epidemiology, Risk Factors, Classification, Genetic Forms

Back 5

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)

Front 6

Clear Cell Renal Cell Carcinoma: Etiology, Origin, Gross morphology, Microscopic morphology, Grading

Back 6

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

Front 7

Papillary Renal Cell Carcinoma: Precursor, Etiology, Microscopic appearance

Back 7

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

Front 8

Chromophobe Renal Cell Carcinoma: Origin, Prognosis, Etiology, Gross morphology, Microscopic morphology

Back 8

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

Front 9

Collecting Duct Carcinoma: Origin, Microscopic appearance, Prognosis

Back 9

1. Origin: epithelium of collecting ducts in medulla of kidney
2. Microscopic appearance: malignant cells in densely fibrotic stroma
3. Prognosis: poor

Front 10

Urothelial Carcinoma of Renal Pelvis: Size, Association, Microscopic appearance

Back 10

1. Size: small at presentation b/c cause hematuria
2. Association: bladder tumour
3. Microscopic appearance: identical to bladder tumour

Front 11

Name 5 types of urinary bladder tumours

Back 11

1. Urothelial tumors: papillary, flat, invasive
2. Squamous neoplasms
3. Glandular neoplasms
4. Neuroendocrine tumours
5. Mesenchymal tumours

Front 12

Urothelial Lesions: Types + Grades + histology

Back 12

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)

Front 13

Testis Tumours Classification

Back 13

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

Front 14

Germ Cell Tumours: Epidemiology, Etiology, Types

Back 14

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

Front 15

Seminoma: Epidemiology, Prognosis, Morphology, Histology

Back 15

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

Front 16

Spermatocytic Seminoma: Epidemiology, Immunohistochemistry, Prognosis

Back 16

1. Epidemiology: Less common than seminoma, over 65, slow growing
2. Immunohistochemistry: PLAP negative
3. Prognosis: excellent

Front 17

Embryonal Carcinoma: Epidemiology, Morphology, Histology

Back 17

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

Front 18

Yolk Sac Tumour: Epidemiology, Prognosis, Morphology, Histology

Back 18

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)

Front 19

Choriocarcinoma: Epidemiology, Morphology, Histology, Immunohistochemistry

Back 19

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

Front 20

Teratoma: Epidemiology, Morphology, Histology

Back 20

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

Front 21

Mixed Germ Cell Tumours: Epidemiology, Common Combinations

Back 21

1. Epidemiology: 65-75% of germ line tumours
2. Combinations: Teratoma+embryonal carcinoma+yolk sac tumour, seminoma+embryonal carcinoma, embryonal carcinoma+teratoma

Front 22

Leydig Cell Tumours: Epidemiology, Secretions, Clinical Presentation, Morphology, Histology, Benign or Malignant

Back 22

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

Front 23

Sertoli Cell Tumours: Benign or Malignant, Secretions, Morphology, Histology

Back 23

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