UROPATHOLOGY - JAN 2022

FRCPath2 Course:

Uropathology Jan 13th 2022 Pedro Oliveira/Dept. Pathology/Christie Hospital, UK (pedro.oliveira1@nhs.net)

The “Challenges”…

Review of the cases Overall approach Some modern concepts Practicalities

Full lecture on video with refs.

CASE 1 - 60-YEAR-OLD MALE. RIGHT ORCHIDECTOMY FOR TESTICULAR TUMOUR .

Why

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Dx: • Spermatocytic tumour

CASE 2 - 27-YEAR-OLD MALE. 10MM DIAMETER LESION LEFT TESTIS

Why

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Dx:

• Sclerosing Sertoli Cell Tumour

CASE 3 - 87-YEAR-OLD MALE. BLADDER BIOPSIES.

Why

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Dx:

• Atypical Squamous Metaplasia suggestive of minimal invasion in one of the sections

CASE 4 - 55-year-old Male. 4cm diameter renal tumour.

Why

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Dx: • Chromophobe RCC initially diagnosed as Clear Cell Type RCC

CASE 5 - 69 -year-old Male. 5cm diameter renal tumour.

Why

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Dx: • Oncocytoma

CASE 6 - 72-year-old Male. Orchidectomy for testicular tumour.

Why

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Dx:

• Leydig Cell Tumour

CASE 7 - 74-year-old Male. Partial penectomy for penile tumour.

Why

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Dx:

• Basaloid Squamous Carcinoma of the Penis

CASE 8 - 28-year-old Male. Radical nephrectomy for right renal tumour (90 x 60 x 60mm).

Why

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Dx: • MIT Translocation Carcinoma

CASE 9 - 72-year-old Male. 2.5cm diameter renal tumour

Why

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Dx:

• Oncocytoma with peri-renal fat involvement

CASE 10 - 27-year-old Male. Left testicular mass.

Why

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Dx: • Seminoma

CASE 11 - 41-year-old Female. Renal mass (100 mm maximum dimension with area of haemorrhage).

Why

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Dx: • Angiomyolipoma

CASE 12 - 30-year-old Male. Foreskin. Sent as ? viral wart ? verruccous carcinoma.

Why

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Dx: • Squamous Cell Carcinoma G2

CASE 13 - 51-year-old Male, nodule seen in prostate on scan. Core biopsies taken.

Why

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Dx:

• Atypical Adenomatous Hyperplasia

CASE 14 - 52-year-old Male. Three week history of right testicular tumour. Slide from orchidectomy.

Why

Case URO14

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Dx:

• Yolk-Sac Tumour with focal Teratoma

CASE 15 - 63-year-old Male. Lump excisied from spermatic cord.

Why

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Dx: • Metastatic ADC

CASE 16 - 39-year-old Male. Urethral stricture.

Why

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Dx: • Nephrogenic Adenoma

CASE 17 - 28-year-old Male. 3.5cm diameter cystic lesion left kidney.

Why

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Dx: • Multicystic Clear Cell Type RCC

CASE 18 - 30-year-old Male. Left orchidectomy for maldescent testis.

Described macroscopically as an atrophic testis. No mass lesion seen macroscopically.

Why

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Dx:

• Germ Cell Neoplasia In-Situ with focal invasive seminoma

CASE 19 - 62-year-old Male. Nephrectomy for left lower pole renal tumour measuring 40mm in maximum dimension (this case has rather poor tissue preservation – it was a pathology review from elsewhere).

Why

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Dx: • Favour Collecting Duct Carcinoma (IHC negative for Urothelial Cell markers)

CASE 20 - 62-year-old Male. Right orchidectomy for tumour.

The tumour replaced almost the whole of the testis.

Why

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Dx: • Seminoma

CASE 21 - 85-year-old Male. Orchidectomy for tumour.

Why

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Dx: • Sex-Cord Stromal Tumour Unclassifiable

CASE 22 - 85-year-old Male. Orchidectomy for tumour.

Why

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Dx: • DLBC Lymphoma

CASE 23 - 71-year-old Male. 55mm diameter renal tumour left upper pole.

Why

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Dx: • Oncocytoma with nuclear atypic

CASE 24 - 68-year-old Male. Prostate core biopsy.

Why

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Dx: • ADC Prostate GG3 with Glomeruloid features

CASE 25 - 84-year-old Male. Bladder abnormal at cystoscopy.

Clinically CIS but not typical appearance.

Why

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Dx: • Lymphoma of the urynary bladder

CASE 26 - 66-year-old Male Male . Radical cystectomy following neoadjuvant chemotherapy (3 slides)

Why

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Dx: • Micropapillary Urothelial Carcinoma

CASE 27 - 20-year-old Male. Indurated areas in foreskin?

Multiple sebaceous cysts.

Why

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Dx: • Granuloma Annulare

CASE 28 - 71-year-old Male. Previous radiotherapy/ hormones for Ca prostate 2003.

Why

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Dx: • ADC Prostate with IDC component

CASE 29 - 22-year-old Male. Bliateral testicular lesions (lumps in testes, unchanged for 10-year-old ). History of atrial myxoma removed 2-year-old ago. Lesion removed from face previously reported as cutaneous mucinosis. Sptiz naevus removed from face 10-year-old ago.

Why

Case URO29

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Dx: • Large Cell Calcifying Sertoli Cell Tumour

CASE 30 - 41-year-old Female. Nepherectomy for tumour. Described as ‘A large well circumscribed variegated mass with extensive central necrosis measuring 145 x 125 x 100 mm situated in 1 pole of the kidney. There is breach in the renal capsule measuring 15 mm in size with soft tissue extruding from it.

The renal vein is infiltrated by tumour. The adrenal gland is not identified. The ureter is not involved.

Why

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Dx: • Adrenal Cortical Carcinoma