Kidney autopsy
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
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.[1]
-
Two glomeruli in diabetic nephropathy: the acellular light purple areas within the capillary tufts are the destructive glomerular matrix deposits.
- Thrombi
-
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
- Crystals
- Atypical or pigmented casts
-
Distal tubular casts (in addition to interstitial inflammation and fibrosis in myeloma cast nephropathy).
Vascular findings
- Thrombi
- Mural deposition of amorphous material
- Vasculitis
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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.
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References
Image sources