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