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PATHOLOGY OF KIDNEYS

PATHOLOGY OF KIDNEYS. VII. practical training 3 rd year General Medicine. Normal glomerulus. 3. 2. 1 Capillary lumen 2 Basement membrane 3 Podocytyes 4 Mesangial cells 5 Proximal tubulus 6 Bowman’s capsule 7 Mesangial matrix 8 Distal tubulus

lucy-cabrera
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PATHOLOGY OF KIDNEYS

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  1. PATHOLOGY OF KIDNEYS VII. practical training 3rd year General Medicine

  2. Normal glomerulus 3 2 1 Capillary lumen 2 Basement membrane 3 Podocytyes 4 Mesangial cells 5 Proximal tubulus 6 Bowman’s capsule 7 Mesangial matrix 8 Distal tubulus 9 Macula densa 1 9 8 1 5 7 6 4

  3. Capillary loops – electronogram Podocytes Podocytal processus Basement membrane Capillary lumen Endothelium 1 Mesangial cell Mesangial matrix

  4. Cystic kidney diseases

  5. Cystic kidney diseases

  6. Infantile cystosis (Microcystosis) of kidneys

  7. Microcystosis

  8. Vascular nephrosclerosis

  9. Vascular nephrosclerosis

  10. Vascular nephrosclerosis

  11. Vascular nephrosclerosis

  12. Classification of glomerular diseases • Primary Glomerular Diseases • Glomerulonefritis in Systemic Diseases • Glomerular Lesions in Vascular Diseases • Glomerular Lesions in Metabolic Diseases • Hereditary Nephropathies • Miscellaneous Glomerular Diseases • End Stage Kidney • Glomerular Lesions Following Transplantation

  13. Non-immunological hyperfiltration BM polyanion loss BM inherited deffects ischemic Immunological circuluting immune complex in situ immune complex anti-basement membrane antibody (anti-GBM) ANCA antibody T-cell mediated cytotoxicity Aetiological clasification of glomerular injury

  14. Nomenclature of glomerular injury • Diffuse - all glomeruli • Focal - some glomeruli, others unaffected • Global - the whole glomerulus • Segmental - only part of the glomerulus

  15. Light microscopic hanges • Proliferative: increased cell numbers (proliferation, PNM and macrophages recruitment from the circulation) • Membranous: BM thickening • Membrano-proliferative: a combination of the two above features • Crescentic: proliferation of cells lining Bowman’s capsule

  16. Diabetic glomerulosclerosis (Kimmelstiel-Wilson) 1 1 hyaline deposits in mesangial matrix of glomerulus

  17. Diabetic glomerulosclerosis (Kimmelstiel-Wilson) 1 2 3 1 hyaline globules in mesangial matrix of glomerulus 2 capillaries around hyaline globules 3 hyalinosis of mesangium

  18. Armani’s cells (PAS)

  19. Endocapillary proliferative glomerulonefritis 2 1 2 2 1 Reduction of capillary lumen 2 Bulge and proliferation of cellular formation of glomerulus

  20. Endocapillary proliferative glomerulonefritisimmunoflourescenc-subendothelial immune-complex deposit 1 1 Granular subendothelial deposits on basal membrane

  21. Endocapillary proliferative glomerulonefritis,electronogram 1 E Swelling endothelial cells 1 Basal membrane Stars- subendothelial deposits of immunoglobulins on basal membrane

  22. Diffuse sclerozing glomerulonefritis

  23. Diffuse sclerozing glomerulonefritis

  24. Rapidly progressive (crescentic) glomerulonephritis 2 2 1 Extracapillary proliferation of epithelial cells of Bowman capsule and fibrin – compression of glomerular capillaries 2 Regresive alteration of glomerular capillaries 1

  25. Rapidly progressive (crescentic) glomerulonephritis 3 3 3 2 1 1 Basal membrane of Bowman capsule 2 Fibrin 3 Hyaline deposits in glomerular capillaries

  26. Acute suppurative pyelonephritis

  27. Acute suppurative pyelonephritis

  28. Acute suppurative pyelonephritis

  29. Chronic pyelonephritis

  30. Chronic pyelonefritis (end stage kidney, anamnesis of prostatic hypertrophy) End stage kidney Dilatated ureter Capsule of kidney Chronic urocystitis Kidney without big changes

  31. Amyloid nephropathy

  32. Amyloid nephropathy

  33. Biliary nephrosis

  34. Hydronephrosis

  35. Hydronephrosis

  36. Wilms’ tumour (nephroblastoma)

  37. Wilms’ tumour (nephroblastoma) 2 3 1 2 1 Stromal component 2 Blastema component 3 Epithelial component 1

  38. Nephroblastoma

  39. Renal cell carcinoma, conventional type Kidney in section tumour Tumour invasion inside vein in hilus Lower pole of kidney

  40. Renal cell carcinoma, clear cell type

  41. Renal cell carcinoma, clear cell type

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