Gross Pathology of the Kidney

Question 1

One lesion

Answer 1

Focal (Gross)

Question 2

Entire Organ

Answer 2

Diffuse (Gross)

Question 3

Has a distinct geometric shape, often used to describe an infarct

Answer 3

Segmental (Gross)

Question 4

Multiple discrete lesions

Answer 4

Multifocal (Gross)

Question 5

< 50% of nephrons (or glomeruli) are involved

Answer 5

Focal (Histology)

Question 6

> 50% of nephrons (or glomeruli) are involved

Answer 6

Diffuse (Histology)

Question 7

< 50% of the glomerular tuft is involved; or only part of the nephron is involved

Answer 7

Segmental (Histology)

Question 8

> 50% of the glomerular tuft is involved

Answer 8

Global (Histology)

Question 9

Used to describe tubulointerstitial lesions, not glomerular lesions

Answer 9

Multifocal (Histology)

Question 10

What does a diagnosis of a tumor type require?

Answer 10

Histology or Cytology

Question 11

What is more common than primary renal neoplasia (kidney creating its own tumor)?

Answer 11

Metastatic or multicentric neoplasia

Question 12

Primary renal neoplasms include:

Answer 12

– Renal cell carcinoma from epithelial cells
– Renal adenoma (benign epithelial; rare)
– Renal sarcoma (malignant mesenchymal; rare)
– Nephroblastoma (from a renal stem cell; common in pig and rat; infrequent in dog)

Question 13

Differentials for red foci:

Answer 13

• Hemangiosarcoma (especially canine) (most common)
  – Dogs can also have retroperitoneal hemangiosarcoma
• Vasculitis (small red spots along vessels or all vessels are congested) (especially in other species)
• Acute hemorrhagic infarcts (wedge shaped)
• Possibly glomerulonephritis (red spots in cortex)
• In renal biopsies, red spots can be normal
  perfused glomeruli

Question 14

What must you prove for it to be Polycystic kidney disease?

Answer 14

You must prove it is genetic
(Persians, Bull terriers, Westies; Prerendale sheep)

Question 15

swelling of one or both kidneys

Answer 15

Hydronephrosis

Question 16

(Hydronephrosis) Swelling of the kidney in one side means obstruction in:

Answer 16

• Ureteropelvic junction
• Ureter
• Ureterocystic orifice

Question 17

(Hydronephrosis) Swelling of the kidney in both sides means obstruction in:

Answer 17

• Urinary bladder
• Urethra
• Both ureters

Question 18

List Differentials for lesions that involve renal papilla/ pelvis

Answer 18

• Hydronephrosis
• Pyelonephritis
• Pyonephrosis (hydronephrosis with pus)
• Nephrolithiasis (Stone / Blood clot)
  – Necrotic papilla

Question 19

• Feline with ethylene glycol
• Bovine with acute tubular necrosis
• Canine with chronic glomerulonephritis

Answer 19

Cases of Acute Azotemia

Question 20

Gross lesions expected with proteinuria / glomerular disease

Answer 20

• Acute glomerular disease will have normally shaped kidneys
• Pallor of the cortex
• With chronic glomerular disease might resemble an end stage kidney
• With protein losing nephropathy might see systemic lesions: ascites, thrombosis

Question 21

Gross lesions expected with chronic kidney disease

Answer 21

• Small kidney
• Often lumpy bumpy, especially in cats
• Loss of entire poles (in cats)
• If one kidney is injured, the other kidney might undergo compensatory hypertrophy

Question 22

Examination of parathyroid glands might help you determine chronicity. Would they be big or small in CKD?

Answer 22

Big

Question 23

What is it called when there are abnormally developed kidneys?

Answer 23

Dysplasia
Maldevelopment
(Misshapen kidneys in young dogs / horses)