Kidney, Bladder and Prostate Neoplasia. David Bingham MD

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1 Kidney, Bladder and Prostate Neoplasia David Bingham MD

2 typical malignant cytology of bladder washings

3 1 benign 2 malignant typical malignant cytology of bladder washings

4 b Bladder tumor

5 Non invasive papillary urothelial carcinoma

6

7 Normal urothelium

8 High grade invasive urothelial carcinoma

9 High grade urothelial carcinoma

10 High grade invasive urothelial carcinoma

11 High grade invasive urothelial carcinoma

12 Bladder carcinoma

13 Urothelial carcinoma of the Bladder Older ages: peak 60s Males > Females 3/1?Urban > rural Occupational associations: chemicals, dyes, paint, rubber industries Smoking

14 Urothelial carcinoma of the Bladder Hematuria, bladder irritative symptoms Diagnosis by urine cytology and transurethral biopsy Most lesions limited at diagnosis, but frequent recurrences and progression Treated with excision, intravesicle chemo and BCG When carcinoma invades the muscle wall, radical cystectomy is indicated

15

16 Urothelial papilloma

17 Urothelial papilloma

18 Urothelial carcinoma in situ

19 Squamous cell carcinoma

20 adenocarcinoma

21

22

23

24 Prostate chips from a TURP

25 Nodular hyperplasia of the prostate

26 Nodular hyperplasia of the prostate

27

28 Needle core biopsies of the prostate

29 Normal prostate glands

30 Atrophic glands Prostatic adenocarcinoma

31 Prostatic adenocarcinoma

32 Prostate carcinoma

33 Prostate carcinoma Older ages US blacks > whites > asians No known smoking association Diagnosed by rectal exam, and needle core biopsy PSA used for screening but lacks specificity and not 100% sensitive

34 Rectal surface Radical resection of prostate

35

36 Prostate carcinoma Gleason grade 3

37 Prostate carcinoma, Gleason grade 4

38 Prostate carcinoma, Gleason grade 5

39

40 P63 stains basal cells in nuclei of normal glands

41 Prostate carcinoma P63 stains basal cells in nuclei of normal glands

42 Prostate carcinoma Latent carcinoma common (30% of men over 50, 70% over 80 have subclinical foci of prostate carcinoma at autopsy) Favorable predictors are small size, low grade, low PSA Even small lesions progress slowly but relentlessly in the absence of treatment

43 Prostate carcinoma: screening Are the cancers detected by screening those which are (or would be) clinically important, or are we detecting some of the latent cancers which would have remained silent during the host s life?

44 Prostate carcinoma metastatic to spine

45

46

47

48 Renal cell carcinoma

49 Renal cell carcinoma, clear cell type

50

51 Renal cell carcinoma, papillary type

52 Renal cell carcinoma, sarcomatoid type

53 Renal cell carcinoma, extending into renal vein

54

55 Multiple renal cell adenomas

56

57 Renal oncocytoma

58 Renal oncocytoma

59

60 angiomyolipoma

61 angiomyolipoma

62

63

64

65

66 Wilms tumor

67 Wilms Tumor (Nephroblastoma) 10% of childhood cancers 90% survive with multimodality therapy Combination of three elements: epithelial tubules, cellular stroma, and undifferentiated blastema Clear cell sarcoma and rhabdoid tumor previously considered to be variants of Wilms tumor are now considered separate entities

68 Wilms tumor

69 Wilms tumor

70 Mesoblastic nephroma

71 Mesoblastic nephroma

72

73

74 Rhabdomyosarcoma botrioides

75 Rhabdomyosarcoma botrioides

76 Rhabdomyosarcoma botrioides

77

78

79

80

81 1Renal cell Transition cell

82 1 renal cell ca 2 urothelial ca 1Renal cell Transition cell

83

84 1 wilms tumor 2 mesoblastic nephroma

85

86 1 normal 2 atrophy 3 hyperplasia 4 carcinoma

87

88 1 urothelial carcinoma 2 carcinoma in situ

89

90

91

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