Kidney autopsy: Difference between revisions
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:*'''Endocapillary hypercellularity''' | :*'''Endocapillary hypercellularity''' | ||
:*Glomerular '''basement membrane thickening and/or duplication''' | :*Glomerular '''basement membrane thickening and/or duplication''' | ||
<gallery mode=packed heights=200> | |||
For 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.<ref name="PerroneChang2017"/> | |||
[[File:Nodular_glomerulosclerosis.jpeg|thumb|Two glomeruli in diabetic nephropathy: the acellular light purple areas within the capillary tufts are the destructive glomerular matrix deposits.]] | |||
:*'''Thrombi''' | :*'''Thrombi''' | ||
<gallery mode=packed heights=200> | |||
File:Histopathology of glomerular crescent formation and thrombi.jpg|'''Thrombi''' (arrows) and glomerular crescent formation (dotted enclosure, in rapidly progressive glomerulonephritis, in this case due to SLE). | |||
</gallery> | |||
*'''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''' | ||
<gallery mode=packed heights=200> | |||
File:Histopathology of myeloma cast nephropathy.jpg|Distal tubular '''casts''' (in addition to interstitial inflammation and fibrosis in myeloma cast nephropathy). | |||
</gallery> | |||
:*'''Crystals ''' | :*'''Crystals ''' | ||
*'''Vascular''' findings | *'''Vascular''' findings | ||
:*'''Vasculitis''' | :*'''Vasculitis''' | ||
<gallery mode=packed heights=200> | <gallery mode=packed heights=200> | ||
File:Histopathology of vasculitis in systemic sclerosis.jpg|Histopathology of vasculitis (in systemic sclerosis): fibromuscular intimal proliferation and adventitial fibrosis | File:Histopathology of vasculitis in systemic sclerosis.jpg|Histopathology of vasculitis (in systemic sclerosis): fibromuscular intimal proliferation and adventitial fibrosis | ||
</gallery> | </gallery> | ||
:*'''Thrombi''' | |||
:*'''Mural deposition''' of amorphous material | |||
==Report== | ==Report== | ||
Revision as of 09:58, 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 (arrows) and glomerular crescent formation (dotted enclosure, in rapidly progressive glomerulonephritis, in this case due to SLE).
- Tubulointerstitial findings
- Interstitial inflammation
- Cytologic atypia in the tubular epithelial cells
- Atypical or pigmented casts
-
Distal tubular casts (in addition to interstitial inflammation and fibrosis in myeloma cast nephropathy).
- Crystals
- Vascular findings
- Vasculitis
-
Histopathology of vasculitis (in systemic sclerosis): fibromuscular intimal proliferation and adventitial fibrosis
- Thrombi
- Mural deposition of amorphous material
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