Uropathology 1 kidney

Pathology Specimens for Urology Residents

Dr Prashant Bansal

SPECIMEN NO 1

• Bilateral nephrectomy specimens.

• The external surface of both kidneys have a

bosselated appearance which is produced by

numerous cysts of varying sizes and

replacing the entire renal parenchyma.

• Cysts are thin walled and translucent and

filled with clear fluid.

• Adult (autosomal dominant) polycystic

kidney disease

• Cut open specimen of kidney. • The kidney is enlarged and replaced by numerous cysts

of varying sizes arising at all levels in the cortex and medulla.

• The cysts are unilocular and are filled with clear serous to hemorrhagic fluid.

• They range from a few millimeters to several centimeters.

• Normal renal parenchyma is not identified. • No mass or papillary lesions seen. • ADPKD

CASE NO 2

• A solitary poorly circumscribed solid grey white tumour is seen involving the upper calyceal system and infiltrating into the renal parenchyma.

• Foci of haemorrhage are identified in the pelvic mucosa.

• The rest of the renal parenchyma appears unremarkable.

• Urothelial carcinoma

CASE NO 4

• Hydatid Cyst Kidney

CASE NO 5

• Grossly hydronephrotic kidney with thinned out parenchyma

CASE NO 6

• Nephroureterectomy specimen

• Small sized kidney

• Grossly dilated and tortuous ureter

• s/o reflux nephropathy

CASE NO 7

• Nephrectomy specimen

• Upper pole mass

• S/o RCC

CASE NO 9

• Solitary well circumscribed exophytic tumour arising from the mid pole of kidney.

• Tumour is tan in colour, homogenous with a central scar.

• Rest of the renal parenchyma shows no significant pathology

Case 4

• Solitary well circumscribed tumour in the upper pole of kidney.

• Tumour is mahogany brown and homogenous.

• No cystic, necrotic or haemorrhagic areas seen.

• Rest of the renal parenchyma shows no significant pathology

• HPE was Chromophobe RCC (not to be commented in exam – JUST say RCC)

Case 6

• Cut open specimen of kidney with dilated pelvicalyceal system.

• The calyceal mucosa has plaques of golden yellow tissue which focally invades the renal parenchyma and extends into the perirenal fat.

• Xanthogranulomatous pyelonephritis

Case 7

Case 9

• Specimen of kidney.

• There is a solid white tumour involving the upper pole of the kidney.

• The tumour extends beyond the renal capsule into the perirenal fat.

• Calculi are embedded within the tumour.

• Squamous cell carcinoma with nephrolithiasis, kidney

Case 10

Case 11

• Renal tumour arising from the lower pole of the kidney. • Tumour is well circumscribed, solid with areas of necrosis. • The ipsilateral adrenal gland shows a tumour with the

same gross appearance as the renal tumour.• The renal parenchyma between the renal tumour and the

adrenal tumour is unremarkable.• The makes the adrenal mass a metastatic lesion and not an

extension from the primary tumour.• Also included in this image is the contra lateral adrenal

gland which appears grossly enlarged, suggesting metastatic involvement.

• (Clear cell RCC with bilateral adrenal metastasis)