26 Renal Tumors

• 1st 3 kidney cancer, RCC most common
• last 3 bladder cancer, transitional most common

RCC

• cigarette and obesity very important

• few pts have classic triad, most just have hematuria

• glycogen/lipids do not stain very well

• N: normal
• circle: yellow mass
• F: fat

• IL 2 part of inflammatory response, like giving flu to someone

• Plush cancer crab in kidney machine: interferon alpha treats renal cell carcinoma

Wilm's

• HTN in children very rare
• average age 3
• tumor in child kidney, think Wilm's
• composed of blastema: primitive kidney tissue
• large unilateral flank mass

• very rare

• neonatal hypoglycemia
• large tongue

Angiomyolipoma

• angio: blood vessel; myo: smooth muscle; lipoma: fat
• cortical tuber: growth or bulge
• very important: leaf-like patches of skin, pale skin in shape of leaf

• Lack of migration
• Neocortical tubers: very hard and white. Glia and neurons jumbled up
• Nodules around ventricles
• Brain tumors SEGA

• top: discolored areas
• SEGA: blocking fluid in ventricles = hydrocephalus. Tube to drain extra fluid

• don't worry about histology.
• Big mass in child

• Looks like fat in middle of kidney

Transitional Cell Carcinoma

• flat pathway: high grade flat tumor then invades. Early p53 mutation
• papillary: low grade papillary tumor that progress to high grade and then invade. Not association with p53

• smoker with hematuria: think bladder cancer
• phenacetin: analgesic
• any industrial job

• Cancer crab belt buckle: cyclophosphamide increases risk of bladder cancer (high grade transitional cell carcinoma)

• cast: glomerular source of bleeding

• platinum used for transitional

Squamous Cell

Adenocarcinoma