Kidney autopsy: Difference between revisions

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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).
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).
File:Histopathology of myeloma cast nephropathy.jpg|Distal tubular '''casts''' (in addition to interstitial inflammation and fibrosis in myeloma cast nephropathy).
File:Histopathology of myeloma cast nephropathy.jpg|Distal tubular '''casts''' (in addition to interstitial inflammation and fibrosis in myeloma cast nephropathy).
File:Histopathology of vasculitis in systemic sclerosis.jpg|Histopathology of vasculitis (in systemic sclerosis): fibromuscular intimal proliferation and adventitial fibrosis
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Revision as of 12:19, 23 December 2019

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 signs 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

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