Renal and urinary tract masses: Pathology review

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Questions

USMLE® Step 1 style questions USMLE

of complete

A 52-year-old man comes to the clinic because of vague right-sided back pain over the past two months. He denies any recent trauma, heavy lifting, or new activity. The patient has also noticed a 4.2 kg weight loss during this time, despite not making any changes to diet or activity. The patient has a 20 pack-year smoking history. The patient’s temperature is 37.8°C (100°F), pulse is 75/min, and blood pressure is 128/85 mm Hg. Physical examination shows no abnormalities. The results of his urinalysis are shown below:  
 
Laboratory value   Result 
 Urinalysis 
 Erythrocytes  60/hpf 
 Leukocytes  4/hpf 
 Bacteria  None 
Which of the following is a possible complication of this patient's condition?  

Summary

Renal and urinary tract masses are abnormal growths that can develop in the kidneys, ureters, bladder, and urethra. These masses may be either cysts or tumors. Renal cysts on ultrasounds appear to be tiny sacs filled with black fluid. Cysts can be either simple or complex when they have septations within. Renal tumors can be benign, like renal oncocytoma, or malignant, like renal cell carcinoma. Common urinary tract tumors include: Renal cell carcinoma: the most common type of renal cancer. It develops in the renal tubules and can metastasize to surrounding tissue. Transitional cell carcinoma: develops in the urothelial cells lining the urinary tract. Wilms' tumor: a rare type of kidney cancer typically affecting children.

Sources

  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Robbins and Cotran Pathologic Basis of Disease" Saunders (2015)
  4. "Fundamentals of Pathology" H.A. Sattar (2011)
  5. "Renal cell carcinoma" The Lancet (2009)
  6. "Gemcitabine and Cisplatin Versus Methotrexate, Vinblastine, Doxorubicin, and Cisplatin in Advanced or Metastatic Bladder Cancer: Results of a Large, Randomized, Multinational, Multicenter, Phase III Study" Journal of Clinical Oncology (2000)
  7. "Maintaining protein stability of ∆Np63 via USP 28 is required by squamous cancer cells" EMBO Molecular Medicine (2020)
Elsevier

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