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33 Cards in this Set

  • Front
  • Back
cells of origin of bladder neoplasm
transitional cell or urothelia cell carcinoma (tcc/ucc)
epidemiology of bladder cancer
50,000 new cases 10k deaths per anum; older adults; smoking; chemicals (2 naphthylamine) ; prior treatment with cyclophosphamide; schistosoma haematobium infection
genetics of bladder cancer
deletion of Ch 9; del 9p21 (involves cyclin dependent kinase inhibitor p16) p53 on 17p
diagnosis of bladder cancer
hematuria; may have granular erythematous mucosa on cystoscopy
pathology of bladder cancer
papillary (similar to benign papilloma which is normal)
staging of bladder cancer
depth of invasion
treatment of bladder cancer
low grade resected; high grade into muscularis propria treated by radical cystectomy; metastacic treated with chemotherapy
common sites of bladder metastases
lung and bone
mesenchymal tumors of bladder
mostly pediatric bladder neoplasms; in adults leiomyosarcoma
rhabdomyosarcoma of bladdedr
small oval or spindled blue cells showing skeletal differentiation; chemotherapy treatment
most common cell of origin for testicular cancer
germ cell tumor 95%; leydig and sertoli the rest
pediatric germ cell tumors
pre pubertal most common are yolk sac and teratoma; mature teratoma good prognosis; yolk sac has metastatic potential
teratomas in ovary vs testis
ovary good prognosis; in testis all teratomas can be bad with metastatic potential
epidemiology testicular cancer
5 times more common in whites than blacks
genetics of testicular cancer
isochromosme 12p present in all cases. inhibition of apoptosis; survival beyond tubular basement membrane
clinical presentation testicular cancer
painless testicular mass; serum CEA AFP beta-HCG; LDH may be elevated; no place for bioplsy because can alter routs of spread and worsen prognosis
tumor markers for testicular cancer
LDH (lactic acid dehydrogenase; elevated especially in NSGCT; non specific; AFP (alpha fetoprotein elevated in mixed NSGCT); beta HCG (beta subunit of chorionic gonadotropin; elevated with mixed NSGCT, also some seminomas); Either AFP and/or betaHCG in almost all NSGCT; elevation following orchiectomy=tumor remains
radiology/staging of testicular cancer
ct of pelvis and abdomen to look for retroperitoneal lymph node metasteses
gross morphology of seminoma
lobulated; pnk-gray; can replace entire testis; confined to testis in majority
microscopic morphology of seminoma
growth in solid sheets; irregular fibrous septa; tumor cells have well defined cell borders w/ CLEAR CYTOPLASM; vesicular nuclei with PROMINIT NUCLEOLI; LYMPHOCYTIC infiltration; occasional granulomas; minority have syncytiotrophoblast cells
teratoma gross appearance
tan, gray, has CYSTS; can be mucoid
teratoma micro appearance
present in up to half of adult mixed NSGCT; pure form in childhood; varying components of all germ layers:skin, bronchial, intestinal, cartilage; if Mature these are differentiated, if Immature they resemble fetal histology (not much prognostic diference in adult nsgct)
yolk sac tumor (endodermal sinus tumor) gross
yellow, possibly mucoid
yolk sac tumor (endodermal sinus tumor) micro appearance
pure tumor in pediatrics; present in 50% NSGCT; many patterns, most common MICROCYSTIC/RETICULAR with lace like arrangements of cuboidal, elongated cells; also solid and myxomatous; AFP immunostains mark epithelial components; hyaline globules characteristic; SCHILLER DUVAL BODIES are characteristic (central capillary surrounded by inner and outer cell layers)
Embryonal carcinoma gross appearance
variegated, yellow-tan, foci of hemorrhage and necrosis
Embryonal carcinoma micro appearance
present in up to half of mixed NSGCT; solid, glandular, and papillary architectures, markedly anaplastic tumor cells, resembling poorly differentiated carcinoma. hyperchromatic nuclei, many with vesicular chromatin and prominent nucleoli; Commonly the vascular-invasive component of mixed GCT
Choriocarcinoma grossly
not usually evident, maybe scar and hemorrhage
choriocarcinoma micro
biphasic population of syncytiotrophoblast and cytotrophoblast, often in background of hemorrhage, necrosis, fibrin, syncytiotrophoblasts are beta HCG immunopositive, large multinucleated cells, smuged chromatin; cytotrophoblasts smaller, regular cuboidal cells, clear cytoplasm
Intratubular germ cell neoplasia (IGCN)
tubules with reduced or absent spermatogenesis, with a few layers composed of atypical cells with enlarged nuclei, prominent nucleoli, clear cytoplasm, similar to seminoma, + for placental alkaline phosphatase (PLAP); seen in conjunction with other germ cell tumors in adults
radiosensitivity of seminoma versus nonseminomatous germ cell tumor
seminoma=radiosensitive NSGCT=nonradiosensitive
tumor confined to testis treatment of seminoma vs NSGCT
orchiectomy + rads to retroperitoneum; vs orchiectomy +surveillance or retroperitoneal node excision
low volume retroperitoneal mets treatment of seminoma vs NSGCT
orchiectomy, rads to retroperitoneum; versus orchiectomy and retroperitoneal node excision, maybe chemo
treatment of GCT with lots of mets
remove testis and give chemotherapy