[08.29a] Patho Lab (ReGuGy) Renal system and Male GU V2.1.pdf

Older adults aged 60 to 70

Which age group is most commonly affected by Renal Cell Carcinoma?

Male

Which sex shows a 2 to 1 preponderance in Renal Cell Carcinoma incidence?

Tobacco use

What is considered the most significant risk factor for developing Renal Cell Carcinoma?

Obesity, hypertension, and estrogen

Name three significant lifestyle or physiological risk factors for Renal Cell Carcinoma besides smoking.

Heavy metals, asbestos, and petroleum

List three industrial or environmental exposures linked to Renal Cell Carcinoma.

75 percent

What is the overall 5-year survival rate for patients with Renal Cell Carcinoma after surgery?

94 percent

What is the 5-year survival rate for Stage I Renal Cell Carcinoma after radical nephrectomy?

79 percent

What is the 5-year survival rate for Stage II Renal Cell Carcinoma after radical nephrectomy?

25 to 50 percent

What is the 5-year survival rate for Renal Cell Carcinoma when there is renal vein involvement?

Renal vein

Renal Cell Carcinoma has a high tendency to invade which specific vascular structure?

Renal calyces and pelvis

Into which parts of the kidney may Renal Cell Carcinoma bulge before fungating towards the ureter?

Costovertebral pain, hematuria, and palpable mass

List the three components of the Renal Cell Carcinoma clinical triad.

Polycythemia

Which systemic symptom, making Renal Cell Carcinoma a great mimic, is caused by increased red blood cell production?

Feminization or masculinization

What endocrine-related systemic symptoms can Renal Cell Carcinoma produce?

Proximal tubular epithelium

From which specific tissue does Clear Cell Carcinoma arise?

Lipids and glycogen

What substances within the cytoplasm give Clear Cell Carcinoma its characteristic appearance?

Trabecular or cord-like

How are tumor cells typically arranged in Clear Cell Carcinoma?

Thin fibrous septa

What structure divides the cells in Clear Cell Carcinoma histologically?

Distinct cell borders

What histological feature helps define the perimeter of tumor cells in Clear Cell Carcinoma?

Off-center nucleus

What is the typical position of the nucleus in Clear Cell Carcinoma cells?

Granular appearance

What variant of renal clear cell carcinoma presents with pinkish cytoplasm?

Distal convoluted tubule

From which part of the nephron does Papillary Carcinoma arise?

MET

Mutations in which proto-oncogene, encoding tyrosine kinase receptors, are associated with Papillary Carcinoma?

Trisomy 7 and 17

Which chromosomal abnormalities are seen in sporadic Papillary Carcinoma?

Foamy macrophages

What specific cell type is found in the stalks of the papillae in Papillary Carcinoma?

Intercalated cells in the collecting ducts

From which specific cells does Chromophobe Carcinoma arise?

Multiple chromosome losses and extreme hypodiploidy

What genetic changes characterize Chromophobe Carcinoma?

Excellent

How is the prognosis described for Chromophobe Carcinoma?

Denser cytoplasm and perinuclear halo

List two histological features of Chromophobe Carcinoma cells.

TFE3

Overexpression of which transcription factor, due to translocation, occurs in Xp11 Translocation Carcinoma?

Bellini Duct Carcinoma

What is another name for Collecting Duct Carcinoma?

Medulla

In which part of the kidney does Collecting Duct Carcinoma arise?

Acute Tubular Necrosis

What clinicopathological entity is characterized by acute renal failure and tubular injury?

More than 50 percent

What percentage of AKI in hospitalized patients is accounted for by Acute Tubular Necrosis?

Ischemic and Nephrotoxic

What are the two primary patterns of Acute Tubular Necrosis?

Ischemic ATN

Which pattern of Acute Tubular Necrosis is associated with inadequate blood flow and shock?

Myoglobin and hemoglobin

Name two endogenous agents that can cause nephrotoxic Acute Tubular Necrosis.

Radiocontrast dyes and organic solvents

Name two exogenous agents that can cause direct toxic injury to the tubules.

Reversible

What is the nature of the Acute Tubular Necrosis process once the injurious agent is removed?

Sloughed into the lumens

What happens to necrotic tubular epithelial cells that become detached from the basement membrane?

Eosinophilic hyaline and pigmented granular casts

Which two types of casts are common in Acute Tubular Necrosis?

Tamm-Horsfall protein

What protein primarily makes up the casts found in Acute Tubular Necrosis?

Tubulorrhexis

What is the term for the rupture of basement membranes in Acute Tubular Necrosis?

Straight portion of PT and ascending thick limb

Which two areas of the nephron are especially vulnerable to Acute Tubular Necrosis?

Magnitude and duration of the injury

Prognosis of Acute Tubular Necrosis is directly correlated with what two factors?

More than 50 percent

What is the mortality rate for Acute Tubular Necrosis in the context of sepsis or multi-organ failure?

Malignant hypertension and microscopic polyangiitis

Name two vascular conditions listed as causes of Ischemic Acute Tubular Necrosis.

HUS, TTP, and DIC

List three systemic conditions associated with thrombosis that lead to Acute Tubular Necrosis ischemia.

Hypovolemic shock

Which form of shock is a common cause of Ischemic Acute Tubular Necrosis?

Focal Segmental Glomerulosclerosis

What is the most common cause of nephrotic syndrome in adults in the US?

Progressive fibrosis

What histological process involves portions of some glomeruli in Focal Segmental Glomerulosclerosis?

Focal

What term describes glomerular involvement where less than 50 percent of all glomeruli are affected?

Diffuse

What term describes glomerular involvement where all glomeruli in both kidneys are affected?

Segmental

What term describes involvement where less than 50 percent of an individual glomerulus is affected?

Global

What term describes involvement where more than 50 percent of an individual glomerulus is collapsed or replaced by fibrosis?

Hyalinosis

What histological feature is seen alongside sclerosis in the collapsed glomerular tuft?

Massive proteinuria, hyperlipidemia, and hyperproteinuria

List three clinical findings of nephrotic syndrome mentioned in the source.

Hematuria

Besides nephrotic syndrome symptoms, what clinical presentation can Focal Segmental Glomerulosclerosis have?

Masson Trichrome

Which stain is best for viewing the blue collagen deposition in Focal Segmental Glomerulosclerosis?

PAS red

Which stain turns hyaline areas and lipid vacuoles red in Focal Segmental Glomerulosclerosis?

Intima

In Focal Segmental Glomerulosclerosis, fibrous tissue may be found within which part of the blood vessel?

Prominent interstitium

What histological finding results from fibrosis surrounding the tubules in Focal Segmental Glomerulosclerosis?

Cryptorchidism

What is the medical term for the complete or partial failure of intra-abdominal testes to descend into the scrotal sac?

Testicular cancer

Cryptorchidism is associated with testicular dysfunction and an increased risk of what?

75 percent

What percentage of cryptorchidism cases are unilateral?

Upper scrotal canal

What is the most common location for an undescended testis at 46 percent?

Inguinal canal

What is the second most common location for cryptorchidism at 42 percent?

Atrophic and far apart

How are the tubules described histologically in cryptorchidism?

Absence of spermatogenesis

What is a primary functional histological feature of cryptorchidism tubules?

Thickened

What happens to the tubular basement membrane in cryptorchidism?

Leydig cells

There is an apparent increase in which interstitial cell type in cryptorchidism?

Sertoli cells

Which specific cells remain within the tubules of an atrophic cryptorchid testis?

Last trimester of pregnancy

When does the testis normally descend into the scrotal sac?

Low birth weight and premature birth

Name two maternal or fetal risk factors for cryptorchidism related to delivery.

Growth restriction conditions

Fetal conditions like Down Syndrome or abdominal wall defects increase the risk of what?

Alcohol, cigarettes, and pesticides

List three maternal or parental exposures that increase cryptorchidism risk.

3 to 5 fold

How much higher is the risk of testicular cancer in a cryptorchid testis?

Intratubular germ cell neoplasia

Testicular cancer in cryptorchidism arises from foci of what?

Contralateral descended testis

Besides the undescended testis, where else can cancer develop in these patients?

Orchiopexy

Which surgical procedure reduces the risk of sterility and cancer in cryptorchidism?

Nodular Prostatic Hyperplasia

What is another name for Benign Prostatic Hyperplasia?

Men older than 50

Benign Prostatic Hyperplasia is the most common prostatic disease in which population?

20 percent

What is the incidence of Benign Prostatic Hyperplasia in men aged 40?

90 percent

What is the incidence of Benign Prostatic Hyperplasia in men aged 90?

Prostatic glands and stroma

Benign Prostatic Hyperplasia involves an increased number of which two components?

Periurethral transition zone

In which specific zone of the prostate does Benign Prostatic Hyperplasia develop?

Discrete nodules

What gross histological structure results in the obstruction of the urethral canal in BPH?

Estradiol

Aging causes an increase in which hormone, leading to more androgen receptors in the prostate?

Dihydrotestosterone

What hormone is the prostate sensitized to by increased androgen receptors in BPH?

Impaired cell death

The increase in cell count in BPH is due to cellular proliferation and what else?

5-alpha reductase

Which enzyme converts Testosterone to Dihydrotestosterone?

FGF and TGF-beta

The binding of DHT to androgen receptors increases the transcription of which two growth factors?

Crowded and larger

How do BPH glands compare to normal prostate glands in size and density?

Complex infolding

Normal prostate glands have less of this histological feature compared to BPH glands.

Basal/Myoepithelial and Secretory

BPH glands are lined by which two layers of cells?

Columnar

What is the cell shape of the inner secretory layer in BPH?

Basal layer

The presence of what surrounding the glands confirms that BPH is not malignant?

Corpora amylacea

What prostatic concretions are exclusive to the prostate gland and serve as a clue for its identification?

Fibromuscular stroma

What type of tissue interlays the hyperproliferative glands in BPH?

60g to 100g

What is the typical weight range of a prostate with BPH?