rdone by: thaer qatishdon't worry this is a normal kidneypatho lab 2 notes\rdone by: thaer...
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Patho lab 2 notes Done by: Thaer Qatish
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Don't worry this is a normal kidney
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This is a simple cyst it has thin & transparent membrane & smooth surface & homogenous fluid inside also it's avascular
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simple cyst
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lobulated
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kidney can be seen in adults
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this starts in the fetus and stays through their life
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interstitial inflammation
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tubular inflammation
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Pyelonephritis = interstitial inflammation + tubular inflammation
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If you zoom in you will see these cells have lobulated membrane (ant shape) this means they are neutrophils unlike the the lymphocytes you will see them as round dark dots
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remember neutrophils means acute inflammation but lymphocytes for chronic inf.
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Acute Pyelonephritis
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Most Common cause of Pyelonephritis is ECOLI
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Also pyelonephritis
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white spaces means cougulative necrosis and it's called Necrotizing papillitis and it happens mostly in diabetes patient
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Necrotizing papillitis
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candidiasis
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candida can cause UTI & pyelonephritis
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normal transitional epithelium taken from the near pelvis of kidney
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the stain that is used is PAS
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Chronic pyelonephritis because these are lymphocytes not neutrophiles
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global sclerosis
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It's normal to see some global sclerosis in adults kidney but it's abnormal if you see segmental sclerosis or too much global sclerosis
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Also chronic pyelonephritis
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looks like cartwheel or clock it's PLASMA cell this also means it's chronic
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Xanthogranulomatous pyelonephritis
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In this disease you will see Foamy macrophages & epithelioid histiocytes
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Foamy macrophages because macrophages will phagocyte fats
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Chronic pyelonephritis can develop to Xanthogranulomatous pyelonephritis
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Xantho = lipid aggregation
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Histiocytes = activated macrophage
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Elongated nucleus this means it's epithelioid histiocytes
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Foamy Macrophages
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Regarding tumors in the kidney we will talk about one benign tumor (Oncocytoma) & 3 malignant tumors 1- clear cells renal cell carcinoma 2-papillary carcinoma 3- chromophobe renal cell carcinoma
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Oncocytoma (benign tumor in the kidney)
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As you see a nuclues surrounded by a large bulky cytoplasm
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In Oncocytoma epithelial cells characterized by abundant acidophilic, granular cytoplasm because of excessive amount of mitochondria. ( it's can be called mitochondroma)
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as the doc. said this tumors resemble Hürthle cell carcinoma of thyriod gland
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Polygonal border of cells حدود واضحة للخلايا
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planed looking nuclei
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summary oncocytoma = eosinophilic granular bulky cytoplasm + polygonal border + planed nuclei
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Also Oncocytoma
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the cytoplasm is not bulky as the previous pic. but it's still eosinophilic and have polygonal borders so it must be ococytoma
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oncocytoma
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Normal
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These are not adipose tissue they are tumors of clear cell renal carcinoma
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they look like NESTS
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If the nucleus is more atypical in shape it's higher grade
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also clear cell renal carcinoma but higher grade than the previous pics. (see how nucleus are more atypical)
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also clear cell renal carcinoma
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papilla is a finger like projection with a core inside it that is full of connective tissue & blood vessels and this core is called fibrovascular core
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FB core
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Remember when we're making the slide we may cut the papilla transversely then we will be looking at it from above like this pic and the next pictures you we see it mostly looks the same
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papillary renal cell carcinoma (must be in the cortex)
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core of papilla
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Also papillary renal cell carcinoma
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this note is not related to the topic and the psammoma is not found here (so don't be confused) psammoma bodies are found in two kinds of papillary tumors 1- papillary carcinoma in thyriod gland 2- papillary serous carcinoma in the ovary
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Papillary tumors but the core filled with foamy macrophages
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foamy macrophages infiltrate FB core
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These are the malignant cells
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clear cytoplasm it's called (perinuclear halo)
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Pale cytoplasm
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chromophobe renal cell carcinoma
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when you see some cells with clear cytoplasm and some others are pale then it's
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chromophobe renal cell carcinoma
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As the doc. said (clear w mesh clear)
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chromophobe renal cell carcinoma
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chromophobe renal cell carcinoma
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Also chromophobe renal cell carcinoma BUT different stain is used it's called Hale's colloidal iron stain
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Remember this stain is SPECIAL for chromophobe renal cell carcinoma .
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Hale's colloidal iron stains the mucins that is found in the cytoplasm of chromophobes with blue colour
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Normal transitional epithelium in the BLADDER
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Remeber all the previous pics. was about the KIDNEY
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IMPORTANT NOTE transitional epithelium = urothelial cells so if we say urothelial carcinoma it's the same as Transitional cell carcinoma
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Transitional cell carcinoma in SITU because there is normal basement membrane
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Unaffected BM the tumors cells didn't cross it
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Cells are hyperchromatic , pleomorphic, and with enlarged nucleus ''BUT'' the thickness of epithelium is normal (SITU)
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Also Transitional cell carcinoma in SITU
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Lamina propria
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Also Transitional cell carcinoma in SITU
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papillary urothelial cell carcinoma(MOST common tumor of the BLADDER)
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Fibrovascular core
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Papillary urothelial carcinoma will be higher in grade if there is more loss of polarity + more mitosis + increase nucleus polymorphism
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intermittent painless gross hematuria is the main symptom of papillary urothelial cell carcinoma specially in ELDERLY and in SMOKERS
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cystoscopy from urethra take biopsy from bladder
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Low grade papillary urothelial carcinoma
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HIGH grade papillary urothelial carcinoma
