Kidney autopsy: Difference between revisions

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==Microscopic evaluation==
==Microscopic evaluation==
The main findings to look for:<ref name="PerroneChang2017">{{cite journal|last1=Perrone|first1=Marie E|last2=Chang|first2=Anthony|last3=Henriksen|first3=Kammi J|title=Medical renal diseases are frequent but often unrecognized in adult autopsies|journal=Modern Pathology|volume=31|issue=2|year=2017|pages=365–373|issn=0893-3952|doi=10.1038/modpathol.2017.122}}</ref>
The main findings to look for:<ref name="PerroneChang2017">{{cite journal|last1=Perrone|first1=Marie E|last2=Chang|first2=Anthony|last3=Henriksen|first3=Kammi J|title=Medical renal diseases are frequent but often unrecognized in adult autopsies|journal=Modern Pathology|volume=31|issue=2|year=2017|pages=365–373|issn=0893-3952|doi=10.1038/modpathol.2017.122}}</ref>
*Glomerular findings
*'''Glomerular''' findings
:*Diffuse and/or nodular mesangial sclerosis
:*Diffuse and/or nodular '''mesangial sclerosis'''
:*Mesangial hypercellularity (which has been defined as more than 3 cell nuclei per peripheral mesangial area on a 4-μm thick tissue section)
:*'''Mesangial hypercellularity''' (which has been defined as more than 3 cell nuclei per peripheral mesangial area on a 4-μm thick tissue section)
:*Endocapillary hypercellularity
:*'''Endocapillary hypercellularity'''
:*Glomerular basement membrane thickening and/or duplication
:*Glomerular '''basement membrane thickening and/or duplication'''
:*Thrombi
:*'''Thrombi'''
*Tubulointerstitial findings
*'''Tubulointerstitial''' findings
:*Interstitial inflammation
:*Interstitial '''inflammation'''
:*Cytologic atypia in the tubular epithelial cells
:*Cytologic '''atypia''' in the tubular epithelial cells
:*Atypical or pigmented casts
:*Atypical or pigmented '''casts'''
:*Crystals.
:*'''Crystals '''
*Vascular findings  
*'''Vascular''' findings  
:*Vasculitis
:*'''Vasculitis'''
:*Thrombi
:*'''Thrombi''''''
:*Mural deposition of amorphous material
:*'''Mural deposition''' of amorphous material


===Alterations in glomerular matrix and/or cellularity===
===Alterations in glomerular matrix and/or cellularity===

Revision as of 09:47, 2 January 2020

Author: Mikael Häggström [note 1]

Basic autopsy cutting

In non-forensic autopsy, cut the kidneys in the coronal planes.

Fixation

Generally 10% neutral buffered formalin.

  See also: General notes on fixation


Microscopic evaluation

The main findings to look for:[1]

  • Glomerular findings
  • Diffuse and/or nodular mesangial sclerosis
  • Mesangial hypercellularity (which has been defined as more than 3 cell nuclei per peripheral mesangial area on a 4-μm thick tissue section)
  • Endocapillary hypercellularity
  • Glomerular basement membrane thickening and/or duplication
  • Thrombi
  • Tubulointerstitial findings
  • Interstitial inflammation
  • Cytologic atypia in the tubular epithelial cells
  • Atypical or pigmented casts
  • Crystals
  • Vascular findings
  • Vasculitis
  • Thrombi'
  • Mural deposition of amorphous material

Alterations in glomerular matrix and/or cellularity

File:Nodular glomerulosclerosis.jpeg
Two glomeruli in diabetic nephropathy: the acellular light purple areas within the capillary tufts are the destructive glomerular matrix deposits.

The most common cause is diabetic nephropathy, and typically presents as glomerular enlargement, mesangial sclerosis basement membrane thickening and and arteriolar hyalinosis.[1]

Other

Report

  • Findings and if they are consistent with already known diagnoses.

Further information: Autopsy

Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. 1.0 1.1 Perrone, Marie E; Chang, Anthony; Henriksen, Kammi J (2017). "Medical renal diseases are frequent but often unrecognized in adult autopsies ". Modern Pathology 31 (2): 365–373. doi:10.1038/modpathol.2017.122. ISSN 0893-3952. 

Image sources