By Stephen M. Bonsib (auth.)
The kidney is an organ with complicated organogenesis prone to quite a few misadventures in improvement and is uncovered to a various array of insults of hematogenous and reduce urinary tract starting place. This Atlas of clinical Renal Pathology presents an summary of the improvement, macroscopic and microscopic good points of the traditional kidney. this can be by way of a accomplished survey of developmental and cystic kidney illnesses, vascular illnesses and tubulointerstitial illnesses. An emphasis is put on gross diagnostic findings with distinctive histological correlates. additionally, the histological, immunofluorescent, immunohistochemical and ultrastructural beneficial properties of the foremost glomerular ailments and renal transplantation pathology are offered. This compendium of non-neoplastic kidney illnesses illustrates the overwhelming majority illnesses you will definitely come across in surgical and post-mortem pathology.
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4 Localized Polycystic Kidney Disease Localized PKD is a rare nongenetic cystic kidney disease in which there is a localized collection of cysts that affect an entire kidney, or a portion of a kidney, with a normal noncystic contralateral kidney. Thus, the lesion also has been also been referred to as unilateral or segmental PKD. The Fig. 71 Localized PKD. This example of localized PKD developed in a 1-year-old child. The cysts are round and fairly uniform in size. They have affected the entire kidney, involving both cortex and medulla.
25 Segmental hypoplasia. This hypoplastic segment from the kidney of a 33-year-old woman shows how narrow the hypoplastic foci may be. Notice the normal cortex on both sides of the lesion and the characteristic abrupt transition. The hypoplastic focus contains thickwalled arteries, dilated veins, and no evidence of normal or sclerotic glomeruli 2 Developmental Anomalies and Cystic Kidney Diseases Fig. 26 Segmental hypoplasia. This image of a lesion from another case shows the abrupt transition from normal cortex to the hypoplastic focus.
Despite the impressive cystic transformation of the kidney in advanced ADPKD, the cysts develop in only 1 % of the nephrons. Progressive cyst expansion damages the remaining nephron population. Fig. 47 ADPKD. In this case of end-stage ADPKD, the entire kidney is cystic. There are several very large cysts. Essentially no normal renal parenchyma is present, making it difficult to distinguish cortex from medulla Fig. 46 ADPKD. These autopsy kidneys in a patient with end-stage ADPKD show markedly enlarged and diffusely cystic kidneys.