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Tumors of Urinary Tract

Tumors of Urinary Tract. Urinary Tract Neoplasm. Renal Tumors Tumors of kidney. Renal Tumors. Renal cell carcinoma. Male > Female :: age 50-70 years. Risk : Smoking, cadmium ( food, battery or plastic factory, Cigarettes ) Acquired cystic disease, von- hippel Lindau syndrome ( Ch 3).

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Tumors of Urinary Tract

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  1. Tumorsof Urinary Tract

  2. Urinary Tract Neoplasm

  3. Renal Tumors Tumors of kidney

  4. Renal Tumors

  5. Renal cell carcinoma • Male > Female :: age 50-70 years. • Risk : • Smoking, cadmium ( food, battery or plastic factory, Cigarettes) • Acquired cystic disease, von- hippel Lindau syndrome ( Ch 3) .

  6. Morphology • Gross: • Yellow, circumscribed mass in upper pole • Invade renal vein→ vena cave and reach right heart ( metastasis). • Invade adrenal → Addison disease. • Microscopic types: • Clear cell carcinoma= MOST COMMON • Papillary carcinoma • Chromophobe carcinoma

  7. Key words ; Renal cell carcinoma

  8. RCC ( clear cell carcinoma) Cancer cells with clear cytoplasm. It contain glycogen. PAS +ve.

  9. RCC • Metastasis: Lung and bone • Bone: produce osteolytic lesion and cause pathological fracture. • Marker of bone mets.: ↑alkaline phosphatase

  10. Clinical for all RCC • Silent • Classic triad: Hematuria, mass, pain or fever. • Paraneoplastic syndromes: • Polycythemia ( erythropoietin):: Hct > 60% • Hypercalcemia ( PTH like hormone) • Cushing syndrome ( ACTH) • Feminization / Musculinization (↑ gonadotrophin).

  11. Wilms tumor ( nephroblastoma) Age: 2-5 y, present as abdominal mass extended into the pelvis. Syndromes: WAGR syndrome Denys-Drash Syndrome Beckwith-widemann Syndrome Genes: WT 1 ( Ch11p13) and WT 2 (11p15). (tumor suppressor gene)

  12. Morphology and prognosis • Gross: lobulated, tan mass • Micro: • Blastemal cells • Epithelial elements • Stroma • Prognosis: • Excellent, long term survival 90%

  13. Morphology Small blue blastemal cells

  14. Transitional cell carcinoma in renal pelvis. Note: Papillary growth; irregular cauliflower like surface. May follow acetaminophen poisoning.

  15. TUMORS OF THE URINARY BLADER AND COLLECTING SYSTEM Usual Type -Transitional Cell Carcinoma (TCC) (Urothelial Neoplasm) Tumors of the Lower urinary tract are about twice as common as renal Cell carcinomas.

  16. It frequently produces obstructive features (common than metastasis).

  17. Types • Transitional cell carcinoma • Squamous cell carcinoma

  18. Transitional cell carcinoma • Male > female :: Age: 40-60 years • Risk (carcinogens) • Smoking • beta naphthylamine, • Chronic cystitis • Aniline dye.

  19. Types:superficial (non invasive) and deep. Most TCC are Papillary tumor, Produce cauliflower like mass

  20. Cauliflower like mass Superficial Papillary tumor

  21. Genes • Superficial neoplasm (tumors): • deletion of Ch 9 • Invasive bladder neoplasm : • Mutation of Rb and TP53 gene.

  22. Squamous cell carcinoma Common in Middle east Risk: Schistosoma hematobium (host is snail). Micro: squamous cell carcinoma

  23. Clinical of all bladder tumor • Pain less hematuria • Urine: atypical cells • Prognosis: • High incidence of recurrence. • Depends upon grade and stage • Bad prognosis • High pleomorphism ( anaplasia) of the cells. • Invasion

  24. Angiomyolipoma. • A hamartoma • Micro: Blood vessels, fat, smooth muscle • Associated with: tuberous sclerosis

  25. THANK YOU

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