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What pathology is indicated by this image?
Hydronephrosis
What pathology is indicated by this image? What is indicated at the tip of the white arrow?
Hydronephrosis & inflammation from an infection
What pathology is indicated by this image? What is indicated at the arrow?
Hydronephrosis & loss of renal parenchyma meaning loss of kindey function and a source of ongoing infection
What pathology is indicated by this image? What is indicated at the arrow?
Hydronephrosis & ureteral calculus
What pathology is indicated at the asterisk?
Hydronephrosis
What pathology is indicated at the asterisk?
hydroureter & hydronephrosis
What is indicated at the arrow?
Long-standing obstruction at junction between ureter and bladder
What pathology is indicated at the asterisk?
Urothelial carcinoma
What pathology is indicated at the asterisk? What exam finding is commonly associated with this pathology?
Urothelial carcinoma & hematuria
What kind of obstructive stone is this?
Calcium oxalate stone
What pathology is indicated by this image?
Prostatic enlargement causing urethral compression shown at the arrow
What kind of obstructive pathology is shown at the arrow?
Urethral stricture
What pathology is indicated by this image?
Urolithiasis - specifically primary oxalosis/oxaluria
What pathology is shown at the arrow? What is the name of the mechanism causing it?
Urolithiasis - supersaturation (increased urinary concentration)
What kind of crystals are shown? What kind of urine is it found in?
Calcium oxalate crystals
Acidic urine
What kind of crystals are shown? What kind of urine is it found in?
Uric acid (urate) crystals
Acidic urine
What kind of crystal is shown?
Cysteine
What kind of crystals are shown?
Ammonium-magnesium phosphate aka struvite stones or staghorn
What kind of crystals are shown?
Ammonium-magnesium phosphate aka struvite stones or staghorn
What kind of crystals are shown?
Ammonium-magnesium phosphate aka struvite stones or staghorn
What kind of crystals are shown?
Uric acid (urate) crystals
What kind of crystals are shown? What kind of urine are they found in?
Triple phosphate
Alkaline urine
What kind of crystals are shown?
Cysteine
What type of cell is shown from this urinalysis? What does it indicate?
Red blood cells → hematuria
What type of cell is shown from this urinalysis? What does it indicate?
Neutrophils (pyuria) → UTI
What type of cell is shown from this urinalysis? What does it indicate?
Eosinophils → Drug induced nephritis, transplant rejection
What broad type of cell is shown in these images of urine?
Leukocytes
What pathology is shown from this image?
Hyperemic mucosa indicating a UTI aka acute cystitis
What pathology is shown from this image and what type of study is used to detect it?
Vesicoureteral reflux evaluated with voiding cystourethrogram
What type of cast is this and what pathology does it indicate? What are the primary clinical signs? What reflux is it associated with?
Leukocyte cast → Acute pyelonephritis
Sudden pain at costovertebral angle, fever, dysuria, frequency, urgency
vesicoureteral reflux
What type of cast is this?
Leukocyte cast
What type of cell is very prominent in this image? What does it indicate?
Neutrophils indicating acute pyelonephritis
This image indicates Polyoma virus at the black arrows…..what clinical diagnosis would this indicate? What is found at the blue triangles?
Pyelonephritis
T lymphocytes
What complication of an acute pyelonephritis is shown at the arrows?
Abscess
What complication of an acute pyelonephritis is shown at the arrow?
abscess formation within kidney tubules
What complication of an acute pyelonephritis is shown?
Cortical abscesses
Small abscess hematogenous spread shown in the image is from what underlying pathology?
acute pyelonephritis
What bug is causing this acute pyelonephritis?
candida
What bug is shown in this cytology sample?
candida
What pathology is shown here?
Chronic pyelonephritis “irregular scarring & blunting of calyces & pelvis”
What pathology is shown here?
Chronic pyelonephritis
What pathology is shown here?
Chronic pyelonephritis showing inflammatory destruction of papillae
What pathology is shown here? What is indicated at the asterisk?
Chronic pyelonephritis
thyroidization
What pathology is shown here?
Xanthogranulomatous pyelonephritis (chronic)
What from this histology slides indicates a Xanthogranulomatous pyelonephritis?
foamy macrophages
What pathology is shown here?
Xanthogranulomatous pyelonephritis (chronic)
What pathology is shown here?
Fibrinoid necrosis in an ANCA related vasculitis
What pathology is shown here?
Nephrosclerosis
What is shown at the asterisk & triangle of this histology of nephrosclerosis?
Asterisk: medial thickening of the small arteries
Triangle: Glomerulosclerosis
What pathology is shown here?
hyaline sclerosis - nephrosclerosis
What pathology is shown here?
fibrotic intimal thickening causing narrowing of the lumen - nephrosclerosis
What pathology is shown here?
one glomerulus with global sclerosis and one with segmental sclerosis (glomerulosclerosis tubular atrophy, interstitial fibrosis and chronic inflammation)
What is the pathology shown here mostly associated with?
hypertension & aging - nephrosclerosis
What pathology is shown here?
nephrosclerosis
What pathology is indicated with the left kidney?
Nephrosclerosis
What pathology is shown in these images?
Hyaline arteriolosclerosis
From this image, what type of injury is indicated with this hyaline arteriolosclerosis? noted from the yellow triangles
type 2 diabetes injury
What is shown here and what is it indicative of?
Fibrinoid necrosis indicating accelerated (malignant) hypertension
What does this image indicate?
fibromuscular dysplasia
What do these “string of beads” indicate?
fibromuscular dysplasia
What do these images show?
Renal infarct
Eosinophillic necrotic tissue (coagulation necrosis)
What do these images show?
Renal infarct
What is indicated by the red in this image?
platelet-fibrin thrombi
What necrosis is shown in these images?
Diffuse cortical necrosis
What is indicated by this photo?
uremic frost - renal failure
What is shown at the green triangles and what is causing it?
hyalinzation (hyalinosis) and sclerosis from CKD
What pathology is indicated?
glomerular disease from an immune mechanism
What pathology is indicated?
Nephrotic syndrome
What pathology is indicated?
Focal segmental* glomerulosclerosis
What is indicated at the red triangle?
HIV-associated and idiopathic collapsing FSGS have the worst prognoses
What is indicated at the arrows? What disease does it indicate?
Effacement of foot processes - minimal change disease
What pathology is indicated?
Membranous nephropathy
What is indicated by these images?
Amyloidosis
What is indicated by these images?
Nephrotic syndrome-amyloidosis
What is indicated by these images?
Diabetic glomerulosclerosis
What is indicated by this image? What is shown at the yellow triangle?
Diabetic glomerulosclerosis
hyaline arteriosclerosis
What is the diagnosis?
What is shown at the green triangle?
What is shown at the red triangle?
What is shown at the white asterisk?
Chronic glomerulonephritis
Hyaline arteriolosclerosis
sclerotic glomeruli
Thinned cortex and tubular atrophy
What is the diagnosis?
What is shown at the red triangle?
Chronic glomerulonephritis
sclerotic glomeruli
What abnormality is this? What are those with this more at risk of?
congenital horseshoe kidney
infections & renal calculi
What is missing at the red arrows?
KIDNEYS!! - renal agenesis
What is indicated by this image?
Renal agenesis-oligohydramnios
What is the name for these physcial exam findings? What condition causes this?
potter facies & talipes equinovarus caused from Renal agenesis-oligohydramnios
What is indicated by these images?
What is wrong with the right kidney?
What can happen from the issue with the left kidney?
(acquired) renal hypoplasia
right: nephrosclerosis
left: increased renin secretion causing HTN
What is going on here?
Renal dysplasia (multicystic renal dysplasia) from
abnormal metanephric differentiation
Explain this histology image of renal dysplasia.
Immature glomeruli, tubules and cartilage are surrounded by loose, undifferentiated mesenchymal tissue (spindled cells) {glomeruli are circled in black}
What do these gross findings indicated?
Renal dysplasia
What do these findings indicate?
Renal dysplasia
What do these findings indicate?
Childhood (juvenile) polycystic kidney disease
What is wrong with this picture?
Childhood polycystic kidney disease \n aka-autosomal recessive polycystic kidney disease (ARPKD)
What caused this child’s kidney to look like this?
Autosomal recessive polycystic kidney disease (ARPKD)
What is indicated by the left kidney? right kidney?
L: ARPKD
R: Multicystic renal dysplasia
What pathology is shown?
Adult polycystic kidney disease
What is shown at the purple arrow? What is the underlying cause?
berry aneurysm from adult PKD
What is shown from these images?
Adult polycystic kidney disease (ADPKD)
What pathology is shown?
Medullary sponge kidney
What pathology is shown?
Medullary cystic kidney disease complex-nephronophthisis
What pathology do these images show?
Simple cysts
What pathology is indicated? What is shown at the yellow stars?
Acute tubular injury (ATI)
Dead cells have sloughed into lumen
What kind of cast is this? What pathology is it associated with?
tubular cast - acute tubular injury
What do these 2 etiologies cause?
acute tubular injury
Note 
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