1. Welcome to the Pathology of the kidney http://library.med.utah.edu/WebPath/RENAHTML/REN ALIDX.html

2. Who am I? 90% fused at: Lower pole

3. Who am I? disorganized architecture, dilated tubules with cuffs of primitive stroma, and an island of cartilage Multicystic renal dysplasia Clue: (press now)

4. Under congenital anomalies Multicystic renal dysplasia Characterized histologically by persistence of abnormal structures – cartilage, undifferentiated mesenchyme, immature CDs and abnormal lobar organization

5. Cystic diseases of kidney Categories 1.Polycystic kidney disease AD (adult) AR (childhood) 2.Medullary cystic disease Medullary sponge Nephronophthisis (not a real word) 3.Acquired (dialysis- associated) 4.Simple cyst

6. Who am I? Outcome – benign CF – microscopic hematuria Pathologic features – single or multiple cysts in normal sized kidneys SIMPLE CYSTS

7. What disease is this related to? Clue (press now)

8. ADPKD Important cause of hypertension in young adults, and cause of progressive chronic kidney failure Cysts develop in cortex and medulla, lined by tubular-type cells Normal tissue exits around cysts but often show nephroscleorosis and chronic interstitial nephropathy Cysts are filled with clear serous fluid or sometimes hemorrhagic fluid

9. Who am I? The cysts have uniform lining of cuboidal cells, reflecting origin from CD Enlarged kidneys, smooth external surface Dilated elongated channels are present at right angles to cortical surface ARPKD

10. Which is medullary sponge kidney and which is acquired cystic disease?

11. Tumors

12. Benign Renal papillary adenoma Angiomyolipoma Oncocytoma

13. What is this? Renal cortical adenoma

14. Malignant tumours Renal cell carcinoma Where do they arise from? Arise from tubular epithelium What are some risk factors? RF: Smoking Obesity (in females) Hypertension Unopposed estrogen therapy Exposure to asbestos, petroleum, heavy metals

15. What type of RCC am I? Clear cell

16. What are the other types of RCC? Papillary carcinoma Chromophobe Collecting duct

17. Who am I? I present often as abdominal mass I am paler, more fleshy and more uniform than other RCC I present most commonly between the age of one and four

18. Urinary tract obstruction and stones

19. Define hydronephrosis Dilation of renal pelvis and calycese associated with progressive atrophy of kidney due to obstruction to outflow of urine What are some common causes of obstruction?

20. What am I? What are the 4 types? Calcium oxalate and phosphate Magnesium ammonium phosphate Uric acid Cystine