Welcome to the

Pathology of the kidneyhttp://library.med.utah.edu/WebPath/

RENAHTML/RENALIDX.html

Who am I?

• 90% fused at:• Lower pole

Who am I?

disorganized architecture, dilated tubules with cuffs of primitive stroma, and an island of cartilage

Multicystic renal dysplasia

Clue: (press now)

Under congenital anomalies

• Multicystic renal dysplasia

• Characterized histologically by persistence of abnormal structures – cartilage, undifferentiated mesenchyme, immature CDs and abnormal lobar organization

Cystic diseases of kidney

• Categories

1. Polycystic kidney disease • AD (adult) • AR (childhood)

2. Medullary cystic disease • Medullary sponge • Nephronophthisis (not a real word)

3. Acquired (dialysis- associated)

4. Simple cyst

Who am I?

• Outcome – benign

• CF – microscopic hematuria

• Pathologic features – single or multiple cysts in normal sized kidneys

• SIMPLE CYSTS

What disease is this related to?

• Clue (press now)

ADPKD

• Important cause of hypertension in young adults, and cause of progressive chronic kidney failure

• Cysts develop in cortex and medulla, lined by tubular-type cells

• Normal tissue exits around cysts but often show nephroscleorosis and chronic interstitial nephropathy

• Cysts are filled with clear serous fluid or sometimes hemorrhagic fluid

Who am I?

• The cysts have uniform lining of cuboidal cells, reflecting origin from CD

• Enlarged kidneys, smooth external surface

• Dilated elongated channels are present at right angles to cortical surface

ARPKD

Which is medullary sponge kidney

and which is acquired cystic

disease?

Tumors

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Benign

• Renal papillary adenoma

• Angiomyolipoma

• Oncocytoma

What is this?

• Renal cortical adenoma

Malignant tumours

• Renal cell carcinoma

• Where do they arise from?

• Arise from tubular epithelium

• What are some risk factors?

• RF: • Smoking • Obesity (in females) • Hypertension• Unopposed estrogen therapy • Exposure to asbestos, petroleum, heavy metals

What type of RCC am I?

• Clear cell

What are the other types of RCC?

• Papillary carcinoma

• Chromophobe

• Collecting duct

Who am I?

• I present often as abdominal mass

• I am paler, more fleshy and more uniform than other RCC

• I present most commonly between the age of one and four

Urinary tract obstruction and stones

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Define hydronephrosis

• Dilation of renal pelvis and calycese associated with progressive atrophy of kidney due to obstruction to outflow of urine

• What are some common causes of obstruction?

What am I?

• What are the 4 types?

• Calcium oxalate and phosphate

• Magnesium ammonium phosphate

• Uric acid

• Cystine