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
The most common cause is diabetic nephropathy, and typically presents as glomerular enlargement, mesangial sclerosis basement membrane thickening and and arteriolar hyalinosis.[1]
Other
-
Thrombi (arrows) and glomerular crescent formation (dotted enclosure, in rapidly progressive glomerulonephritis, in this case due to SLE).
-
Distal tubular casts (in addition to interstitial inflammation and fibrosis in myeloma cast nephropathy).
-
Histopathology of vasculitis (in systemic sclerosis): fibromuscular intimal proliferation and adventitial fibrosis
Report
- Findings and if they are consistent with already known diagnoses.
Further information: Autopsy
Notes
- ↑ 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
Image sources