Renal Pathology 3 Flashcards
What is the most common type of GloNeph Worldwide?
IgA Nephropathy
What is seen on micro in IgA Neph?
LM: Mesangial Proliferation
IF: Mesangial IgA
EM: Mesangial deposits
What is Alport Syndrome?
Defect of GBM due to mutation of gene for a5 chain ofCollagen TIV X-Dominant: In males, Fe carry Sensoneural Deafness Microscopic Hematuria Progresses to Renal Failure Proteinuria on progression
What is seen on micro in Thin GBM disease?
LM: Normal
IF: Normal
EM: thin GBM
What is seen in Lupus Nephritis?
Granular immune complex deposit of IgG, IgA, IgM, C3, C4
ONLY GM Disease with ALL Ig Deposition
How does diabetic Nephropathy present?
Proteinuria, nephrotic synd, chronic Renal failure
What is seen in Amyloidosis in the Kidneys?
Amyloid gets trapped in: Glomeruli, BV, Tubules
GBM becomes leaky to proteins => Nephrotic Synd
What are the 2 types of Acute Tubular Necrosis?
Ischemic
NephroTOXIC
What are the causes of NephroTOXIC Acute tubular Necrosis?
Dr: Aminoglycosides, Ampho B, Gentamycin Mercury Carbon Tetrachloride Radiocontrast dyes Myoglobin in Rhabdomyolysis
What drugs cause drug induced HSR?
Synthetic Penicillins
Rifampin
Ibuprofen
Thiazide Diuretics
What is presentation of Drug induced HSR?
2 weeks later: Fever, eosinophelia, rash, and acute renal failure
What is Ascending Pyelonephritis?
Ascending from Reflux or Obstruction
Hematogenous
Acute: Neutrophils
Chronic: Lymphocytes, scars
What causes Acute Pyelonephritis?
Infections of the pelvicalyceal system and renal parenchyma
How is acute pyelonephritis diagnosed?
WBC (neutrophil)casts, Urine culture
What is the presetaion of Acute Pyelonephritis?
Pain in the Costo-vertebral angle +other signs of infection
What is Charicteristic of Chronic Pyelonephritis?
Insidious or Recurrent acute
Gradual loss of Renal function
Leads to Scarred Kidney w/ chronic Inflammation
What is Thyroidization in Chronic Pyelonephritis?
Dilated Tubules with intraluminal eosin staining proteinaceous material
Where is a papillary adenoma usually found?
ALWAYS in the CORTEX
What disease is Tuberous Sclerosis associated with?
Tuberous Sclerosis
What is the gross appearance of Papillary adenoma?
Pale Yelow, well circumscribed nodules
What is an Angio-myo-lipoma?
Thick walled vessels
Smooth muscle
Fat
What are the risk factors of Renal Cell Carcinoma?
TOBACCO Chronic Renal Failure and ACQUIRED CYSTIC RENAL DISEASE Obesity HTN Unopposed estrogen therapy Asbestos Heavy metals
What are the symptoms of Renal Cell CA?
Hematuria 50-60% Abdominal Mass (25-40%) Flank pain HTN Weight loss Fever
What structure is INVADED by RCC?
RENAL VEIN!!!
What is Clear Cell RCC?
Loss of tumor supressor gene VHL
What is Papillary RCC?
Activation of Pro-oncogene MET
What is Chromophobe RCC?
Loss of multiple chromosomes resulting in hypodiploidy
Best prognosis among Clear and Papillary
What is the Gross Appearance of Clear Cell RCC?
Solitary Unilateral Lesion
Yellow-Orange
Margins sharply defined
Grey-White necrosis and hemorrhagic Discoloration
What is the microscopic appearance of Clear Cell RCC?
Tumor cells have a rounded or polygonal shape
Clear or granular Cytoplasm
Abundant Capillaries
What is seen on micro of Chromophil (Papillary) RCC?
Papillary structures that enclose clusters of foamy macrophages
Eosinophilic cytoplasm atypical nuclei
Sparse Macrophages
What is the difference between Clear Cell RCC and Papillary RCC?
CCRCC: Abundant clear Cytoplasm + Abundant Capillaries
PapRCC: Eosinophilc pink cytoplam
Sparse Capillaries
What syndrome is associated with increased RCC?
Von Hippel Lindau Syndrome
What is the Most common malignancy of Ealry childhood 2-4yo?
Wilms tumor
What causes Wilms tumor?
LOF mutation of tumor supressor genes WT1 or WT2 on Chr 11
What is the presentation of Wilms Tumor?
Huge, palpable flank mass, and Hematuria
What is the key lesion in ALport syndrome?
Basket weave lesion
What is the Stain and appearance of Amyloidosis in the kidney?
Congo Red
Apple green birefringence
