Term
|
Definition
|
|
Term
| what is 85% of primary kidney tumors |
|
Definition
|
|
Term
| who gets renal carcinoma: gender, age |
|
Definition
|
|
Term
| pathology of renal carcinoma: tissue type, color, location, cell description |
|
Definition
growth of renal tubular cortex epithelium
well defined yellow orange mass on upper pole with processes into parenchyma
cells are vacoulated (lipid-laden) or solid |
|
|
Term
| 4 risk factors for renal cell carcinoma |
|
Definition
smoking
cadmium
dialysis acquired cysts
polycystic kidney disease |
|
|
Term
| 3 types of renal cell carcinoma, which is more common |
|
Definition
clear cell 80%
papillary renal cell carcinoma
chromophobe renal carcinoma |
|
|
Term
| how does sporadic clear cell carcinoma present |
|
Definition
| single tumor on upper pole of kidney |
|
|
Term
| cause of familial clear cell carcinoma |
|
Definition
loss of VHL tumor supressor on 3-25 increases IGF and HIF which increases VEGF and PGDF
associated with von hippel lindau |
|
|
Term
| what are the tumors of von hippel lindau |
|
Definition
| hemangioma of cerebellum, retina, other neoplasms |
|
|
Term
| presentation of familial clear cell carcinoma |
|
Definition
| hundreds of bilateral kidney masses |
|
|
Term
| clear cell renal carcinoma: grade, metastasis locations |
|
Definition
very invasive
often extends through calyces, pelviz, ureters, enters RENAL VEIN as far as right atrium
high incidence of metastasis: lung, bone, regional nodes |
|
|
Term
| signs of clear cell renal carcinoma: 4 |
|
Definition
classic triad: hematuria, palpable mass, flank pain
other symptoms depending on the paraneoplastic association |
|
|
Term
| what are the 4 paraneoplastic types of clar cell renal carcinoma and the outcome |
|
Definition
ACTH: cushing syndrome
PTH: hypercalcemia
renin: HTN
erythropoetin: polycythemia |
|
|
Term
| causes of papillary renal cell carcinoma |
|
Definition
familial or sporadic
CH7 trisomy causes amplification of MET (TK) causing growth of PCT epithelium |
|
|
Term
| papillary renal cell carcinoma: color, characteristics, location, |
|
Definition
multiple bilateral papillary growth pattern
less yellow (less lipid than clear cell), necrosis, hemorrhage, cystic |
|
|
Term
| chromophobe renal carcinoma cause |
|
Definition
| intercalated cells of the CD have lost many chromosomes (hypodiploidy) |
|
|
Term
| chromophobe renal carcinoma: color, appearance, location, size |
|
Definition
stain dark
tan brown
nuclei with halos of clear cytoplasm
macrovesicles |
|
|
Term
| what is the 3rd most common cancer in kids |
|
Definition
|
|
Term
| who gets wilms tumor: age |
|
Definition
|
|
Term
|
Definition
| deletion or mutation in WT1/WT2 on Ch11 |
|
|
Term
| 3 syndromes associated with wilms tumor |
|
Definition
WAGR syndrome
denys drash syndrome
beckwith weidmann syndrome |
|
|
Term
|
Definition
wilms tumor
aniridia: no iris
ganital abnormalities: hyposapdias, epispadius
mental retardation |
|
|
Term
| signs of denys drash syndrome 3 |
|
Definition
gonadal dysgenesis
renal abnormalities
wilms tumor |
|
|
Term
| cause of beckwith weidemann syndrome |
|
Definition
improper genomic imprinting: region Ch11 normally on paternal CH (maternal is silenced).
in disease maternal copy is not imprinted (is active) and IGF-2 is over produced |
|
|
Term
| signs of beckwith weidmann syndrome 2 |
|
Definition
wilms tumor
organomeagly: tongue, kidney, hemihyprotrophy (entire body segments) |
|
|
Term
| wilms tumor: cell type, color, characteristics, size |
|
Definition
blastoma (kidney mesoderm precursor cells) make primitive glomeruli, tubules, and stroma
well circumscribed, soft, large, tan/gray, focal hemorrhages/necrosis
"tumor makes its own kidney" |
|
|
Term
| clinical signs of wilms tumor 5 |
|
Definition
palpable abdominal mass,
abdominal pain, fever, hematuria, intestinal obstruction |
|
|
Term
|
Definition
| survival for 2y implies recovery is possible |
|
|
Term
| 5 congenital abnormalities of the ureters |
|
Definition
double ureters
ureteroprlvic junction obstruction
diverticula
hydroureter
megaloureter |
|
|
Term
| double ureter: define, complication |
|
Definition
derived from double or split ureteral bud
can cause obstruction of flow |
|
|
Term
| urteropelvic junction obstruction: who gets it, location |
|
Definition
usually in infant boy left ureter (most common cause of hydronephrosis in kids)
adults more common in women unilateral |
|
|
Term
| diverticula: cause, definition, complication |
|
Definition
congenital or acquired
saccular outpouching of ureteral wall that allows for stasis and infection |
|
|
Term
| hydroureter: cause, define |
|
Definition
congenital or acquired, may be nephrogenic defect in ureteral musculature innervation
dilation, elongation, and toursity of the ureters |
|
|
Term
| megaloureter: define, complications |
|
Definition
enlarged ureter due to functional deficit in ureteral muscle
hydronephrosis and decreased renal function |
|
|
Term
| what is the inflammation of the ureter called |
|
Definition
|
|
Term
|
Definition
usually component of UTI
ureteritis cystica: glandular metaplasia due to persistant infection/damage causing chronic inflammatory changes |
|
|
Term
| 4 obstructive lesions of the ureters |
|
Definition
hydronephrosis
hydroureter
pyelonephritis
sclerosing retroperitoneal fibrosis |
|
|
Term
| sclerosing retroperitoneal fibrosis: age, cellular changes, complications, disease associations |
|
Definition
middle aged
fibrous and inflammatory proliferation encases retroperitoneal structures causing obstructive hydronephrosis
ormond disease |
|
|
Term
| ormond disease: cause, location, triggers |
|
Definition
autoimmune reaction causes IgG4-secreting plasma cells to activate
often in pancreas and retroperitonium and salivary glands
triggers: drugs, malignancy, idiopathic |
|
|
Term
| 3 neoplasms of the ureter, are they benign or malignant |
|
Definition
benign primary neoplasias: fibroepithelial polyps, leiomyomas
primary malignant tumors: usually transitional cell carcinoma |
|
|
Term
| fibroepithelial polyps: appearance, locations 4 |
|
Definition
small mass projecting into lumen
more common in left ureter
also in bladder, pelvis, urethra |
|
|
Term
| primary malignant ureter tumors: location, age, cell type |
|
Definition
usually transitional cell carcinoma
simillar to those in renal pelvis, calyces, and bladder
50-60yo |
|
|
Term
| 5 congenital abnormalities of the bladder |
|
Definition
diverticula
exstrophy
vesicureteral reflux
congenital fistulas
persistant urachus |
|
|
Term
| diverticula: cause, changes in tissue |
|
Definition
congenital defect or persistant urethral obstruction (like BPH)
obstruction or increased vesicular pressure causes thickening of bladder wall and outpouching |
|
|
Term
| diverticula: clinical signs |
|
Definition
usually asymptomatic
if symptomatic means it made area of stasis and allowed for infection, caliculi, and carcinoma (gets through muscle wall fast)
predisposition to vexicuroetal reflux |
|
|
Term
|
Definition
| developmental failure causes bladder wall to flatten and protrude through abdomen wall |
|
|
Term
|
Definition
| chronic infection and inflammation, increased carcinoma risk (esp adenocarcinoma) |
|
|
Term
| complications of vesicoureteral reflux |
|
Definition
| predisposition to chronic pyelonephritis |
|
|
Term
| what is a congenital fistula |
|
Definition
| connection between bladder, vagina, rectum or uterus |
|
|
Term
| what is a persistant urachus |
|
Definition
fistulous urinary tract between bladder and umbilicus
allows for formation or urachal cysts which allow carcinoma and infection |
|
|
Term
| what are the 4 types of cystitis |
|
Definition
infectious
hemorrhagic
suppurative/ulcerative
chronic |
|
|
Term
| causes of infectious cystitis 4 |
|
Definition
e. coli
proteus
klevesebella
enterobacter |
|
|
Term
| caises of hemorrhagic cystitis |
|
Definition
cytotoxic antitumor trugs (cyclophosphamide)
bladder radiation
adenovirus |
|
|
Term
| cause of suppurative/ulcerative cystitis |
|
Definition
| ulceration and sloughing of large areas of mucosa |
|
|
Term
| cause of chronic cystitis |
|
Definition
| persistence of infection causes fibrous thickening of muscularis propria decreasing bladder elasticity |
|
|
Term
|
Definition
urinary frequency (15-20min)
abdominal pain: suprapubic
dysuria: pain with urination
systemic: fever, chills, malaise |
|
|
Term
| 3 types of non-infectious cystitis |
|
Definition
interstitial - possibly autoimmune
polyploid
malacoplakia |
|
|
Term
| signs of interstitial cystitis 7 |
|
Definition
| urgency, frequency, hematuria, dysuria, intermittent severe suprapublic pain, female, no bacterial infection |
|
|
Term
| tissue changes in interstitial cystitis 5 |
|
Definition
cytoscopic fissures
punctuate hemorrhages
hunner ulcers: mucosal ulcers
later: transmural fibrosis
later: contraction of all layers |
|
|
Term
| cause of polyploid cystitis, effect |
|
Definition
irritation of bladder mucosa due to injury (usually catheter)
uroepithelium is thrown into broad bulbous polyploid projections causing submucosal edema |
|
|
Term
| what does papillary urothelial carcinoma often look like |
|
Definition
|
|
Term
|
Definition
chronic infection (E. coli, proteus)
immune supression
macrophage defects (overload with bacterial products) |
|
|
Term
| location of malacoplakia 6 |
|
Definition
| colon, lungs, bone, kidney, prostate, epididumis |
|
|
Term
| malacoplakia: color, size, density, cell types |
|
Definition
macroscopic, soft, yellow, 3-4cm, mucosal plaques
macrophages stuffed with bacterial remnants
multinuclate giant cells
michaelis-gutman bodies: macrophage lysosomes with Ca deposits |
|
|
Term
| what are 4 metaplasias of the bladder |
|
Definition
cystitis glandularis
cystitis cystica
intestnal or colonic metaplasia
squamous metaplasia |
|
|
Term
| how is cystitis glandularis identified |
|
Definition
| brunn nest: lesion in bladder transitional epithelium grows down onto lamina propria and transforms into cuboidal or columnar epithelium |
|
|
Term
| what does cystitis cystica look like |
|
Definition
| cystic spaces lined by flattened urothelium |
|
|
Term
| intestinal or colonic metaplasia: how does this affect bladder |
|
Definition
| glblet cells resembling intestinal mucosa form in bladder |
|
|
Term
| cause of squamous metaplasia |
|
Definition
| thickening in response to injury |
|
|
Term
| bladder epithelium and mesenchyme tumors: prevelance, most common type, |
|
Definition
>57,000/y and increasing
usually transitional cell carcinoma
<5% true squamous cell carcinoma |
|
|
Term
| urethelial neoplasms: location, general changes |
|
Definition
benign to agressive, high risk of death
multifocal in any site with urothelium (renal pelvis to urethra)
keratinization, chronic irritation, infection |
|
|
Term
| two urethelial neoplasm precursor lesions |
|
Definition
non-invasive papillary tumor
carcinoma in situ |
|
|
Term
| cause of non-invasive papillary tumor |
|
Definition
| papillary urothelial hyperplasia |
|
|
Term
| urethelial neoplasm carcinoma in situ: cell type, different shapes and their prognosis |
|
Definition
cytologically malignant cells
flat urothelium
full thickness or urethrlium
pategoid spread: scattered malignant cells in urine often loose cohesiveness spread and seed |
|
|
Term
| 4 types of urethrlial neoplasm |
|
Definition
papilloma
non-invasive papillary urothelial neoplasm of low malignant potential (grade I urothelial carcinoma)
grade II urothelial carcinoma (low grade papillary urothelial carcinoma)
grade III urothelial carcinoma (high grade urothelial carcinoma) |
|
|
Term
| papillary urothelial carcinoma: who gets it, prevelance, shape, prognosis |
|
Definition
young patients
1% of bladder tumors
small finger like papillae identical to normal urothelium
does not progress to cancer, rarley reoccurs |
|
|
Term
| noninvasive papillary urothelial neoplasm of low malignant potential prognosis |
|
Definition
| rarley invasive, may reoccur after removal |
|
|
Term
| grade II urothelial carcinoma: appearance, prognosis |
|
Definition
rarley invasive
rarley life threatning
papillary exophytic growth with cellular arypica |
|
|
Term
| grade III urothelial carcinoma: two types, their prognosis |
|
Definition
papillary
flat: highly agressive, rapid progression |
|
|
Term
| squamous cell carcinoma of bladder: prevelance, cause, appearance, prognosis |
|
Definition
3-7% of US cancer
more frequent with schistomiasis endemics
cover large area of bladder
deeply invasive |
|
|
Term
|
Definition
| malignancy of gland cells (not normally in bladder so came) from urachius elements on bladder dome |
|
|
Term
| adenocarcinoma complications |
|
Definition
histologically identical to adenocarcinoma of the GI
rare varients include highly malignant signet ring cell carcinoma |
|
|
Term
|
Definition
| connects fetal duct to yolk sack allowing bladder to drain waste through dome of bladder to umbilical cord |
|
|
Term
| bladder cancer: age, gender, common cause |
|
Definition
more in men, industralized nation, urban
80% 50-70yo
usually not familian |
|
|
Term
| risk factors for bladder cancer |
|
Definition
#1 smoking
industrial: arylamines (B-naphyline) for 15-40y
schistoma hematobium endemics
long term analegesics
long term cyclophosphamide
radiation: years after exposure, other pelvic malignancies |
|
|
Term
| what cancer does schistoma hematobium usually cause |
|
Definition
mostly SCC, rest TCC
increases keratinization |
|
|
Term
| 4 steps in bladder neoplasm clinical course |
|
Definition
PAINLESS HEMATURIA: sometimes only sign
frequency, uregency, dysuria
external urethral oriface hydronephrosis or pyelonephritis
after excision: new tumors of high grade develope |
|
|
Term
| what are the factors involved in progression free survival of bladder cancer |
|
Definition
early detection is key (catch in lamina propria)
grade, lamina propria invasion, associated CIS |
|
|
Term
| what is the worse type of bladder cancer |
|
Definition
|
|
Term
| where does bladder cancer metastasize locally 5 |
|
Definition
prostate, seminal vesicles, ureters, retroperitonieum
fistula to vagina or rectum |
|
|
Term
| where does bladder cancer metastasize distandly and how |
|
Definition
| hematogenous dissemination (rare) to liver, lungs, marrow |
|
|
Term
| what is the mainstay of diagnosis of bladder cancer |
|
Definition
|
|
Term
| what is the inflammation of urethra called, what are two tyopes |
|
Definition
| urethritis: gonoccal, non-gonoccal |
|
|
Term
| cause of gonococcal urethritis |
|
Definition
| early manifestation of N. gonococcus |
|
|
Term
| cause of non-conoccal urethritis |
|
Definition
| E. coli, GNB (coliforms), chalmydia |
|
|
Term
| signs of non-gonoccal urethritis |
|
Definition
cystitis in females
prostatitis in males
reiter syndrome |
|
|
Term
| 3 signs of reiter syndrome |
|
Definition
arthiritis
conjunctivitis
urethritis |
|
|
Term
|
Definition
not a serious clinical problem in itself
local pain
itching
frequency |
|
|
Term
|
Definition
urethral caruncle
primary carcinoma |
|
|
Term
| urethral caruncle: size, location, color, cause |
|
Definition
| small, red mass on external urethral meatus in females due to chronic irritation of prolapsed urethra |
|
|
Term
| urethral caruncle: who gets it |
|
Definition
any age
usually post menopause women |
|
|
Term
| urethra caruncle: morphology |
|
Definition
friable
trauma causes ulceration and bleeding
may mimic carcinoma
small red mass |
|
|
Term
| primary carcinoma of urethra: who gets it, associations |
|
Definition
usually advanced aged females
cancers also occur within prostatic urethra |
|
|
