at autopsy
by staining positive for human melanoma black (HMB)-45
by fine-needle aspiration cytology
by exclusion
A. at autopsy
. What is an indication for radical nephrectomy?
a 6-cm, polar tumor
bilateral RCC
locally advanced RCC
1
2
3
4
. The second most common RCC subtype is:
collecting duct b. clear cell
papillary
chromophobe
. What is false regarding radical nephrectomy operation?
nodal involvement doesn`t influence prognosis
renal artery should be ligated before the vein to avoid kidney ballooning
cardiopulmonary bypass with deep hypothermic circulatory arrest is performed in patients with supra-diaphragmatic tumor thrombi
the central scar on CT or MRI, and the spoke-wheel pattern of vessels on angiograms are not specific to oncocytoma
calcification, necrosis, and hemorrhage are rare in oncocytomas
it is thought to arise from the basement membrane of proximal convoluted tubules
treatment is partial nephrectomy or tumor excision
. What is false concerning imaging studies for preoperative evaluation of RCC case?
in case of bone pain or elevated serum calcium and/or alkaline phosphatase levels, an isotopic bone scan is required
renal arteriography accurately localizes central scaring and tumor necrosis
trans-esophageal echocardiography helps assess vena caval and right atrial tumor thrombi
papillary RCC
renal metastases
renal oncocytoma
renal xanthogranuloma
clear cell
chromophobe
papillary
renal medullary
. What is NOT an indication for simple nephrectomy?
symptomatic chronic renal infection with poor function
some cases of renovascular hypertension
symptomatic calculus disease with poor renal function
. Manifestations of paraneoplastic syndrome associated with RCC include all of the following, EXCEPT:
anemia and erythrocytosis
hepatic dysfunction and elevated human chorionic gonadotropin levels
hypocalcemia
fibrosarcoma
leiomyosarcoma
carcinoid
adult Wilm`s tumor
right hydrocele
left varicocele
painless hematuria
hypertension
glomerulocystic kidney disease
developmental cystic renal disease
Juvenile nephronophthisis
medullary cystic kidney disease
mutations in the MCKD1 (chromosome 1q21) gene
mutations in the MCKD2 (chromosome 16q12) gene
inherited in an autosomal dominant fashion
all of the above
glomerulocystic kidney disease (GCKD)
Juvenile nephronophthisis (JNPHP)
medullary cystic kidney disease
all of the above
autosomal recessive polycystic kidney disease
autosomal dominant polycystic kidney disease
multicystic dysplastic kidney disease
juvenile nephronophthisis
. What is the most common histologic subtype of renal sarcomas?
rhabdomyosarcoma
nephrosarcoma
leiomyosarcoma
20%
30%
40%
50%
I
II
III
IV
margin status and grade
tumor size
tumor stage
the time interval between the tumor emergence and excision
is > 90% in Bosniak type IV renal cysts
in patients receiving renal transplants for polycystic kidney disease is 48% higher than that expected in the general population
all of the above
simple renal cysts might turn malignant in < 4% of cases
most lesions ≤ 4 cm are asymptomatic
renal masses with fat content is pathognomonic for AML
renal biopsy from AML carries a high risk of hemorrhage
may coexist with malignant lesions, such as sarcomas and RCCs
nuclear size, outline, and nucleoli
cohesiveness and the degree of cellular atypia
chromatin structure and content of the interphase nucleus
multinucleation and mitosis
they follow a benign clinical course
they have a bimodal age distribution
they are more common in men than in women
none of the above
70 - 85%
55 - 70%
40 - 55%
25 - 40%
autosomal dominant polycystic kidney disease (ADPKD)
developmental cystic renal disease
inherited cystic renal disease
systemic disease with associated renal cysts
cyst aspiration and sclerosis
partial nephrectomy
endoscopic marsupialization and fulguration of the cyst
administration of TKIs
is the first and most reliable radiologic examination to study IVC thrombi
is reserved for patients with equivocal MRI or CT findings
is obsolete and has fallen out of use
carries a risk of IVC terrible bleeding that outweighs the diagnostic merits
papillary subtype of RCC has a tendency to multifocality
chromosome 13 alterations are common in the development of clear cell renal carcinoma
a solid mass on CT that enhances more than 15 HU is suggestive of RCC
bilateral involvement in RCC either synchronously or metachronously occurs in 2% to 4% of patients
acquired cystic renal disease
juvenile nephronophthisis
medullary sponge kidney
bilateral multicystic dysplastic kidney