Urinary Practical Slides 205

Horseshoe kidney : -Gross pic showing fused of the lower part of the kidney -It is afunctioning kidney - It is almost always in pelvis

The kidney cannot ascendbecause it is prevented by the mesenteric artery

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Poly cystic kidney (adult): - enlarged - multiple cystic spaces -the spaces may be small or large, these spaces filled either with : -Clear fluid -Hemorrhagic red fluid -Common Cause of Death (chronic renal failure) -other less common: 1- cerebral hemorrhage 2- Heart Failure

Kidney Showing multiple cyst ,varies insize and it contain atrophic tissue between cysts

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prolifrative streptococcal glomerulonephritis: Microscopic Picture Showing: - large glomerulus - few tubules around - hyper cellular glomerulus - capillaries poorly defined -some cells have divided nucleus ( more than 1 part ) - Neutrophils infiltration

- high power light microscopic picture - capillaries almost closed some often contains neutrophils -

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Most important point: Glomerulus enlarged Hypercellular glomerulus Neutrophils infiltration

-Granular fluorescence - (immuonofluorescence microscopic picture ) - showing clear glomerulus - fluorescence deposited on capillaries wall -causes : 1- acute post streptococcal glummeropathy 2- membranous glummeropathy

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- Electron microscope picture - show a large despite on the basement membrane - this deposition is subendothelial, called " Hump " - occurs in poststreptococcal prolifrative glomerulonephritis

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Gross picture shows - rapid progressive glomerulonephritis - enlarged kidney -cut section shows : 1- areas of hemorrhage 2- pale areas ( away from hemorrhage )

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Microscopic picture Shows: 2 glomerulus surrounded by tubules Crescent formation, characteristic of " rapid progressive glomerulonephritis "

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Immuonofluorescence picture Shows: Anti-glomerular basement membrane disease Linear fluoresces capillary wall, which is characteristic Thickened glomerular capillary wall E.g rapidly progressive " ……………….. "

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- Microscopic pic Shows: Glomerulus with Markedly thickened capillary wall “Diffuse thickening in peripheral capillary wall” Dx, Membranous glomerulonephritis

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-subendothelial deposite separated by spikes -‫مش حجيبها في المتحان و حتيجي‬ ‫في النظري‬

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-immuonofluorescence microscopic picture Showing : - clear glomerulus -fluorescence deposited on capillaries wall -causes : 1- acute post streptococcal glummeropathy 2- membranous glummeropathy Same As Slide 5 ‫يعني إذا قال يبغى‬ Diagnosis ‫تكتب أي وحدة من السببين‬ ‫وإذا قال يبغى‬ Causes ‫تكتب السببين‬ a6ba.com

‫مش حتيجي في المتحان‬ ‫دي ما فيهاش أي‬ ‫ابنورمالتي ‪ ,‬بس شوية‬ ‫‪ cells‬زيادة‬

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Minimal change disease EM pic showing diffuse footprocess

‫تاني مش حاتيجي صور‬ ‫زي دي في المتحان‬

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diabetic nephrosclerosis ))mostly nodular : Microscopic pic Showing Glomerulous showing something red, homogenous and has no nuclei (hyalinization of the (glomerulous Diabetes causes (fibrosis and sclerosis of the glomerulous) after that they . causeshyalinization Diabetic nephrosclerosis is : 2 type Nodular.1 Diffuse.2 If the diabetic nephrosclerosis is mostly of thenodular type we call . itkimmelsetiel-wilson a6ba.com

Dx.Renal cell carcinoma Gross pic showing dissected kidney which has a mass yellowish not encapsulated located in the upper pole and it shows hemorrhage and ‫)طالعة لبرا ومرفوعة‬.necrosis (‫من مكانها‬

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‫صورة قديمة ومش‬ ‫حاجيها ليكم‬

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Renal cell carcinoma Micro Pic : composed of 2 : types of cells Clear cell which is large.1 nothing around the nucleus Granular cell which is.2 small red cell Renal cell carcinoma is adenocarcinoma

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Wilm’s tumor : Gross Pic Pale grayish large mass infiltrate most of the kidney tissue has hemorrhage and .necrosis Mixed tumor Carcinoma(epithelial) or sarcoma(connective (tissue

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wilm’s tumor-23 a6ba.com : Micro: there are three types of cells undifferentiated blastema.1 “mesenchymal tissue “the sarcoma part of the tumor.2 ” epithelial tissue (forms tubules and glomerulous) “the carcinoma part.3

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HyderonephrosisEnlarged kidneyhas multiple cystic . spaces Large cyst open ineach other, lined by thick whitish material and filled with think .pus Pressure atrophy of.the adrenal cortex Q.how to differentiate between hydronephcosis andcongenital polycystic? disease Thecongenital polycystic disease is usuallydiffused to all the kidney and the cyst are not openin each other ( the cysts are separated from ( each other

Papillary tumor Microscopic pic shows Thin delicate highlyvascularised connective tissue layer covered by transitional cell epithelium They form finger like projection which forms the velli ” villous papilioma” The thickness of the papilloma is 7 layers or less of transitional epithelial But in carcinoma it is” . “more than 7 layers a6ba.com

Gross: opened urinary bladder infiltrated by irregular mass shows multiplefinger like projection we said it is” transitional because it “is multiple masses The carcinoma of the :bladder are either squamous cell-1 carcinoma(usually it is solid( mass transitional cell-2 carcinoma (usually it ( ispapillary

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It is of the high grades because it infiltrate the bladder “extensive infiltration of the ” bladder

There is papilarymasses but most of it are solid so this is High grade transitional cell carcinoma

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Transitional cell carcinoma :Micro Connective tissue cord covered by transitional epithelial more than 7 layers Has pleomorphism & mitosis, may has mass under the connective ( tissue (sign of invasion

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