# Patho Block Ib
## Urinary Pathology
## Cancers
- Medullary carcinoma
- lymphoplasma cell infiltration
## Reproductive Pathology
### Disease of female genital tract
#### Cancers
- VIN (vulvar intraepithelial neoplasia)
- classic: HPV16
- differentiated: TP53
- Serous carcinoma
- High grade:
- BRCA-related
- 從TIC (tubal intraepithelial carcinoma) of fallopian tube來的
- Mucinous carcinoma
- intestinal type (KRAS)
- seromucinous type (ARID1A)
- Endometrioid carcinoma
- Type 1
- Low grade: microsatellite instability, PTEN, ARID1A, CTNNB1 mutations
- High grade: TP53 mutation
- Type 2
- TP53 mutation
- Yolk sac tumor
- Alpha fetoprotein
- Choriocarcinoma
- beta-HCG
- germ cell (non-gestational, pure type): chemotherapy-resistant
- Endometriosis-associated tumor
- Mucinous borderline tumor, endocervical-like (müllerian, seromucinous) type
- Sex cord-stromal tumors
- **Granulosa cell tumors**:
- **estrogenic**
- **Call-Exner body**
- Fibromas
- Sertoli-Leydig cell tumors (Androblastoma)
- DICER1 gene mutation
- Gonadoblastoma: coexists with dysgerminoma
#### Others
- Gartner duct cyst
- Wolffian duct（mesonephric duct） 遺跡
- Hydatidiform Mole 葡萄胎 (complete & partial)
- P57KIP2 paternally imprinted, as tumor suppressor
- partial: fetal parts
- complete:
### Disease of female breast
- HER2-positive，high-proliferation，包含 ER +/-
- related to Li-Fraumeni syndrome
- Stewart-Treves syndrome
- 在 edema 處 (arm) 長出angiosarcoma
- Phyllodes tumor: from intralobular stroma
### Disease of male genitalia
#### paratesticular cancer
- Adenomatoid tumor
### Others
- Orchitis
- mumps
## Renal Pathology

### Nephritis
- RPGN (Rapidly Progressive GN, crescentic glomerular change)
- Inflammation
- Type 1: anti-GBM: Goodpasture syndrome
- Type 2: IC: APSGN, SLE, IgA nephropathy
- Type 3: Pauci-immune (ANCA+): Wegener granulomatosis, microscopic polyangiitis
- Berger disease
- IgG hinge region galactosylation defect
- Mesangial matrix expansion and hypercellularity
- Mesangial deposition of IgA and C3 (alternative pathway)
- **Hematuria (Berger, Lupus nephritis, Alport syndrome)**
- Alport syndrome
- Basket weave change of GBM
- Transplantation glomerulopathy (不知道要放哪個分類)
- peritubular capillaries C4d deposits
### Nephrosis
- Membranous glomerulonephritis (GN)/nephropathy
- Subepithelial IgG
- Membranoproliferative GN
- Type 1:
- IgG
- subendothelium
- Type 2:
- C3
- GBM, Bowman's & renal tubule lamina densa
- FSGS (focal segmental glomerulosclerosis)
- cyclosporin chronic toxicity (也跟atypical hemolytic uremic syndrome [aHUS]有關)
- foot process effacement
- podocyte detachment
- HIV-associated nephropathy
- collapsing FSGS
- interstitial inflammatory infiltrate
- cystic dilated tubules
- tubuloreticular inclusions
- Diabetic nephropathy
- arterial hyalinization
- proteinuria
- GBM thicken
- Kimmelstiel-Wilson nodule: Nodular glomerulosclerosis： class III 的變化，形成一個一個 acellular nodule。 nodule 裡無細胞核，又稱為 Kimmelstiel-Wilson nodule。
- **Double contour**
- Membranous GN: IC spike
- Membranoproliferative GN: mesangial cell
### Disease of vessels
- Nephrosclerosis:
- benign: HTN --> ischemic obsolescence: BM shrink, wrinkling change, hyaline arteriolosclerosis
- malignant: fibrinoid necrosis, onion skin
### Cancer
* Papillary carcinoma
* HGF, MET gene mutation
* Clear cell RCC
* VHL mutation
* related to von Hippel-Lindau syndrome
* Angiomyolipoma
* related to tuberous sclerosis
### Gene disorder
- PKD (polycystic kidney disease)
- Adult: polycystin mutation
### Excretory Pathology
- Interstitial cystitis
- Hunner ulcer