Horseshoe kidney :

-Gross pic showing fused of the lower

part of the kidney
-It is afunctioning kidney
- It is almost always in pelvis

The kidney cannot ascend-

because it is prevented by the
mesenteric artery

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 Poly cystic kidney (adult):
- enlarged
- multiple cystic spaces
-the spaces may be small or large, these
spaces filled either with :
-Clear fluid
-Hemorrhagic red fluid

-Common Cause of Death (chronic renal

failure)
-other less common:
1- cerebral hemorrhage
2- Heart Failure

Kidney Showing multiple cyst ,varies in-

size and it contain atrophic tissue
between cysts

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prolifrative streptococcal
glomerulonephritis:
Microscopic Picture
Showing:
- large glomerulus
- few tubules around
- hyper cellular glomerulus
- capillaries poorly defined
-some cells have divided nucleus
( more than 1 part )
- Neutrophils infiltration

- high power light microscopic picture

- capillaries almost closed
some often contains neutrophils -

Most important point:

Glomerulus enlarged
Hypercellular glomerulus
a6ba.com Neutrophils infiltration
 -Granular fluorescence
- (immuonofluorescence
microscopic picture )
- showing clear
glomerulus
- fluorescence deposited
on capillaries wall
-causes :
1- acute post
streptococcal
glummeropathy

2- membranous
glummeropathy

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 - Electron microscope
picture
- show a large despite
on the basement
membrane
- this deposition is
subendothelial, called "
Hump "
- occurs in
poststreptococcal
prolifrative
glomerulonephritis

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 Gross picture
shows
- rapid progressive
glomerulonephritis
- enlarged kidney
-cut section shows :
1- areas of hemorrhage

2- pale areas ( away from

hemorrhage )

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 Microscopic picture
Shows:
2 glomerulus surrounded by
tubules
Crescent formation,
characteristic of " rapid
progressive
glomerulonephritis "

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 Immuonofluorescence
picture
Shows:
Anti-glomerular basement
membrane disease
Linear fluoresces capillary
wall, which is
characteristic
Thickened glomerular
capillary wall
E.g rapidly progressive "
……………….. "

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 - Microscopic pic
Shows:
Glomerulus with Markedly
thickened capillary wall
“Diffuse thickening in
peripheral capillary wall”
Dx, Membranous
glomerulonephritis

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 -subendothelial deposite
separated by spikes

-‫مش حجيبها في المتحان و حتيجي‬

‫في النظري‬

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 -immuonofluorescence
microscopic picture
Showing :
- clear glomerulus
-fluorescence deposited
on capillaries wall
-causes :
1- acute post
streptococcal
glummeropathy

2- membranous
glummeropathy

Same As Slide 5

‫يعني إذا قال يبغى‬

Diagnosis
‫تكتب أي وحدة من السببين‬
‫وإذا قال يبغى‬
Causes
‫تكتب السببين‬
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 ‫مش حتيجي في المتحان‬

‫دي ما فيهاش أي‬

‫ابنورمالتي ‪ ,‬بس شوية‬
‫‪ cells‬زيادة‬

‫‪a6ba.com‬‬
 Minimal change disease
EM pic showing diffuse foot-
process

‫تاني مش حاتيجي صور‬

‫زي دي في المتحان‬

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 diabetic nephrosclerosis
))mostly nodular
: Microscopic pic Showing
Glomerulous showing
something red,
homogenous and has no
nuclei (hyalinization of the
(glomerulous

Diabetes causes (fibrosis

and sclerosis of the
glomerulous) after that they
. causeshyalinization
Diabetic nephrosclerosis is
: 2 type
Nodular.1
Diffuse.2
If the diabetic
nephrosclerosis is mostly
of thenodular type we call
. itkimmelsetiel-wilson

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 Dx.Renal cell carcinoma
Gross pic showing
dissected kidney which
has a mass yellowish not
encapsulated located in
the upper pole and it
shows hemorrhage and
‫)طالعة لبرا ومرفوعة‬.necrosis
(‫من مكانها‬

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 ‫صورة قديمة ومش‬
‫حاجيها ليكم‬

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 Renal cell carcinoma

Micro Pic : composed of 2

: types of cells
Clear cell which is large.1
nothing around the
nucleus
Granular cell which is.2
small red cell

Renal cell carcinoma is

adenocarcinoma

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 Wilm’s tumor -
: Gross Pic
Pale grayish large
mass infiltrate most of
the kidney tissue has
hemorrhage and
.necrosis

Mixed tumor
Carcinoma(epithelial)
or sarcoma(connective
(tissue

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 wilm’s tumor-23 a6ba.com
: Micro: there are three types of cells
undifferentiated blastema.1
“mesenchymal tissue “the sarcoma part of the tumor.2
” epithelial tissue (forms tubules and glomerulous) “the carcinoma part.3
 Hyderonephrosis-
Enlarged kidney-
has multiple cystic
. spaces
Large cyst open in-
each other, lined by
thick whitish material
and filled with think
.pus
Pressure atrophy of-
.the adrenal cortex
Q.how to differentiate
between
hydronephcosis
andcongenital
polycystic? disease
Thecongenital
polycystic disease
is usuallydiffused to
all the kidney and the
cyst are not openin
each other ( the cysts
are separated from
( each other
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 Papillary tumor

Microscopic pic shows

Thin delicate highly-
vascularised connective
tissue layer covered by
transitional cell
epithelium

They form finger like -

projection which forms
the velli
” villous papilioma”

The thickness of the

papilloma is 7 layers or
less of transitional
epithelial

But in carcinoma it is”

. “more than 7 layers

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 Gross: opened urinary
bladder infiltrated by
irregular mass shows
multiplefinger like
projection

we said it is”
transitional because it
“is multiple masses
The carcinoma of the
:bladder are either
squamous cell-1
carcinoma(usually it is
solid( mass
transitional cell-2
carcinoma (usually it
( ispapillary

It is of the high grades

because it infiltrate
the bladder “extensive
infiltration of the
” bladder
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 There is papilary-
masses but most of it
are solid so this is
High grade
transitional cell
carcinoma

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 Transitional cell
carcinoma
:Micro
Connective tissue cord
covered by transitional
epithelial more than 7
layers
Has pleomorphism &
mitosis, may has mass
under the connective
( tissue (sign of invasion

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