Harp GU Images

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