Renal Tumours
·
Most people have one or two
·
Associated with renal scarring
·
< 5 mm diameter
· Papillary architecture
·
No clear cells (if there were
then malignant)
· Renal Oncocytoma: Have oncocytes: cells with abundant mitochondria (pink and granular) – tired epithelial cells. Grossly form a stalate scar
· Renal fibroma
·
Aniomyolipoma: composed of fat,
smooth muscle and thick blood vessels. Associated with Tuberous Sclerosis
·
75% of renal epithelial tumours
in adults
·
Annual incidence 3/100,000
·
Risk factors: smoking, obesity,
hypertension, unopposed oestrogen
·
3% familial, Von Hippel-Lindau
disease
·
Clinical features: haematuria,
back pain, abdominal mass. Often
metastasised before diagnosis
·
Histology:
o Clear Cell Renal Cell Carcinoma – most common
§ Metastasise up the renal vein to the heart ® emboli ® cannon
ball metastasis of the lung
§ Sheets of clear cells
§ 3 p25 deletion diagnostic feature
o Papillary RCC: Better prognosis
o Chromophobe RCC: Better prognosis, large cells, abundant cytoplasm,
small dark nucleus
o Sarcomatoid RCC: Highly malignant, highly anaplastic
·
Present with painless haematuria
·
Can cause hydronephrosis, flank
pain, and renal colic from clots
·
Peak in 6th – 7th decade, M > F
·
Derived from epithelium of renal
pelvis
·
Associated with smoking, analgesic
abuse, azo dyes
·
Often associated with
transitional cell carcinoma of the bladder and ureter
·
Very aggressive, presents with
abdominal mass with or without haematuria. Pain and intestinal obstruction can
occur
·
50% present < 3 years, 90%
< 10 years, rare in adults
·
Derived from metanephric blastema
o Dark with scant cytoplasm
o Triphasic histology: epithelial cells, stromal cells, blastema
·
Now around 80% cure
·
Associated with syndromes:
o WAGR: Wilms, aniridia, genital anomalies and mental retardation
o Denys Drash Syndrome: Gonadal dysgenesis, nephropathy
o Beckwith-Wiedemann syndrome
·
Angiomyolipoma: Benign – but grow
and haemorrhage. Composed of fat, smooth muscle and dilated blood vessels
·
Juxtaglomerular Cell Tumour: Very rare, benign but causes malignant
hypertension
Related Topics
Privacy Policy, Terms and Conditions, DMCA Policy and Compliant
Copyright © 2018-2024 BrainKart.com; All Rights Reserved. Developed by Therithal info, Chennai.