Tract Tumors JUdoctors泌尿系肿瘤ppt课件.pptx

Urinary Tract Tumors;Renal Cell Carcinoma (RCC);Predisposing factors ;New classification based on the molecular origins of these tumors ;1-Clear Cell Carcinomas;VHL disease ;Those with VHL syndrome inherit a germ-line mutation of the VHL gene on chromosome 3p25 and lose the second allele by somatic mutation. The VHL gene is also involved in the majority of sporadic clear cell carcinomas (60%). homozygous loss of the VHL gene seems to be the common underlying molecular abnormality in both sporadic and familial forms of clear cell carcinomas ;2-Papillary Renal Cell Carcinomas;familial cases: trisomy of chromosome 7 activating mutations of the MET gene. sporadic cases: duplication or trisomy of chromosome 7 but there is no mutation of the MET gene. chromosomal translocation involving chromosome 8q24 close to the c-MYC gene, is also associated with some cases of papillary carcinoma;3-Chromophobe Renal Carcinomas;Renal cell carcinoma: typical cross-section of yellowish, spherical neoplasm in one pole of the kidney. Note the tumor in the dilated, thrombosed renal vein. ;Renal cell carcinoma High-power detail of the clear cell pattern;Clinical Course ;Paraneoplastic syndromes: 1-hypercalcemia 2-Hypertension 3-Cushing syndrome 4-feminization or masculinization The prevalent locations for metastases are the lungs and the bones. may invade the renal vein and grow within this vessel, sometimes extending as far as the inferior vena cava and even into the right side of the heart. ;Wilms Tumor ;Wilms tumor of the kidney ;Wilms tumor nests and sheets of dark blue cells at the left with compressed normal renal parenchyma at the right.;The tumor shows attempts to form primitive glomerular and tubular structures ;Bladder cancer ;Urothelial tumors ;Transitional cell carcinoma of UB;Urothelial (transitional) cell carcinomas;Papillary Urothelial (transitional) carcinoma-low grade ;squamous cell carcinomas;Clinical Course;Predisposing factors : Bladder cancer is not familial.