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    Renal System: DR - Hafiz Muhammad Bilal Saleh

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    This document discusses several cases involving the renal system. Case 1 involves a 37-year-old male presenting with back pain and CT scan revealing a mass in the kidney with hematoma. The diagnosis is angiomyolipoma, which contains bundles of smooth muscle cells and fat cells. Case 2 involves examining a photomicrograph to identify renal cell carcinoma based on clear cell cytoplasm and nests with intervening blood vessels. Case 3 involves a 3-year-old child brought in with an abdominal mass, diagnosed as Wilms' tumor, which has an incidence of 1 in 10,000 and can occur in extrarenal sites. Case 4 discusses clinical presentations of Wilms' tumor such as abdominal mass, pain, or hemat

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    Renal System: DR - Hafiz Muhammad Bilal Saleh

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    uzmabhatti34
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    This document discusses several cases involving the renal system. Case 1 involves a 37-year-old male presenting with back pain and CT scan revealing a mass in the kidney with hematoma. The diagnosis is angiomyolipoma, which contains bundles of smooth muscle cells and fat cells. Case 2 involves examining a photomicrograph to identify renal cell carcinoma based on clear cell cytoplasm and nests with intervening blood vessels. Case 3 involves a 3-year-old child brought in with an abdominal mass, diagnosed as Wilms' tumor, which has an incidence of 1 in 10,000 and can occur in extrarenal sites. Case 4 discusses clinical presentations of Wilms' tumor such as abdominal mass, pain, or hemat

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    This document discusses several cases involving the renal system. Case 1 involves a 37-year-old male presenting with back pain and CT scan revealing a mass in the kidney with hematoma. The diagnosis is angiomyolipoma, which contains bundles of smooth muscle cells and fat cells. Case 2 involves examining a photomicrograph to identify renal cell carcinoma based on clear cell cytoplasm and nests with intervening blood vessels. Case 3 involves a 3-year-old child brought in with an abdominal mass, diagnosed as Wilms' tumor, which has an incidence of 1 in 10,000 and can occur in extrarenal sites. Case 4 discusses clinical presentations of Wilms' tumor such as abdominal mass, pain, or hemat

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    Download as pptx, pdf, or txt
    35 views21 pages

    Renal System: DR - Hafiz Muhammad Bilal Saleh

    Uploaded by

    uzmabhatti34
    This document discusses several cases involving the renal system. Case 1 involves a 37-year-old male presenting with back pain and CT scan revealing a mass in the kidney with hematoma. The diagnosis is angiomyolipoma, which contains bundles of smooth muscle cells and fat cells. Case 2 involves examining a photomicrograph to identify renal cell carcinoma based on clear cell cytoplasm and nests with intervening blood vessels. Case 3 involves a 3-year-old child brought in with an abdominal mass, diagnosed as Wilms' tumor, which has an incidence of 1 in 10,000 and can occur in extrarenal sites. Case 4 discusses clinical presentations of Wilms' tumor such as abdominal mass, pain, or hemat

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    RENAL SYSTEM

    Dr.Hafiz Muhammad Bilal Saleh

    CASE 1

    A 37 years old male presented with back pain.


    CT scan reveals a mass in kidney with
    associated hematoma.

    a) Give your diagnosis?


    b) Describe its two histological features?
    c) Name extra-renal sites of this lesion?
    d) With which disease, this tumour is most commonly associated?

    ANSWERS
    a)
    b)

    c)
    d)

    Angiomyolipoma
    (1) bundles of atypical smooth muscle cells radiating
    from arteries (2) well formed mature fat cells admixed
    with the smooth muscle cells.
    Liver, pelvis, retroperitoneum, chest, large bowel, nasal
    cavity and bone.
    Tuberous sclerosis. 25-30%.

    CASE 2

    Carefully examine the given photomicrograph


    and answer the following questions:

    1. 1. Identify the lesion?


    2. 2. Give two points of identification
    in favor of your diagnosis?
    3. Name the histological types of this
    lesion?

    ANSWERS

    1. Renal cell carcinoma


    2. (i) Neoplastic cells have clear cytoplasm
    (ii) Neoplastic cells are arranged in nests with
    intervening blood vessels
    3. Clear cell carcinoma
    Papillary carcinoma
    Chromophobe renal carcinoma
    Collecting duct (Bellini) carcinoma

    CASE 3

    1.

    A mother brought her 3 years old child to the clinic with


    complaint of feeling of large abdominal mass during
    handling. The mass was resected surgically
    Identify the given specimen and give your diagnosis

    2. Give the incidence rate of this lesion?


    3. Name the extra renal sites of this lesion?

    ANSWERS
    1. Wilms tumour (Nephroblastoma)
    2. Incidence: 1 in 10,000
    3. Mediastinum,testis,uterus,inguinal
    canal,retroperitoneum.

    CASE 4

    What are the clinical presentations of Wilm


    Tumor ?

    ANSWER 4
    Asymptomatic abdominal mass ( 80 % )
    Abdominal pain or hematuria ( 25 % )
    UTI and varicocele ( Less common )
    Hypertension, gross hematuria and fever( 5-30%)

    CASE 4

    A 45 years old woman came in emergency with complaints


    of hematuria for three months and flank pain for 2 days on
    right side. On inquiry, she gave history of NSAIDS use for
    five years due to osteoarthritis. O/E, right kidney is
    palpable
    1. What is your likely diagnosis?
    2. How will you investigate her?
    3. Write down three risk factors of this lesion?

    ANSWERS

    1.Urothelial tumor of renal pelvis


    2. USG,IVP,Retrograde pyelography,CT scan
    3.Smoking,cyclophosphamide,raditions,analgesics

    CASE 5

    A 40 years male, who is known case of CRF, came to the


    dialysis unit for dialysis and gave H/O intermittent
    hematuria and diagnosed as having renal cell carcinoma
    (RCC)
    1. Name 3 classical diagnostic clinical features of RCC
    2. What paraneoplastic syndromes are associated with
    RCC?
    3. What is 5-year survival rate of patients with RCC?
    4. What is the treatment of choice?

    ANSWERS
    1. Costovertebral pain, palpable mass, hematuria
    2. Polycythemia, hypercalcemia, leukemoid
    reaction, amyloidosis, hypertension, hepatic
    dysfunction, Cushing syndrome, eosinophilia.
    3. Nephrectomy

    RENAL CYST
    A fluid-filled sac arising from a dilatation in any
    part of the nephron or collecting duct

    NONGENETIC
    Acquired disorders
    1. Simple renal cysts - solitary or multiple
    2. Cysts of the renal sinus (lymphangiectasis)
    3. Acquired cystic kidney disease (in patients with
    chronic renal impairment)
    4. Multilocular cyst (multilocular cystic nephroma)
    5. Hypokalemia-related cysts Developmental
    disorders

    GENETIC
    Autosomal-dominant
    1.

    Autosomal-dominant polycystic kidney disease

    2.

    Tuberous sclerosis complex

    3.

    Von Hippel-Lindau disease

    4.

    Medullary cystic disease

    5.

    Glomerulocystic kidney disease

    THANK YOU

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