Casts of neutrophils in the urine

#GROSS

#Diagnosis 👉🏻 Papillary necrosis


#The_white_arrows
Necrosis
ونوع الـ necrosis هو coagulative necrosis

CHRONIC PYELONEPHRITIS

✫divided into two forms:
- chronic obstructive pyelonephritis
يسبب dilatation of the pelvis and calyx with pus and inflammatory cell
وتسمى Pyonephrosis
- chronic non obstructive pyelonephritis
وتسمى pyelonephritis


✫Gross description
- The kidney is atrophy
وبسبب هذا تكون كمية fat التي حول الكلى اكثر من الطبيعي.
- irregular in the surface
- Thickening and adherant of capsule
- hemorrhage and scarring in the cortical
In the cut section
The cortex and medulla indifferentiated due to fibrosis.


✫Microscopic description
- Perglomerular fibrosis ( pink and thick)
- Glomerular sclerosis
وهذا العلامتين توجد ايضاً في حالة focal & segmental glomerulonephritis
وأيضاً في حالة membranous nephropathy
- Interstitium ➪increase in stroma or fibrosis in the stroma
وبسبب هذا عمل compression on tubules التي اصبحت atrophy
- tubules atrophy
بيحصل فيها compensation بيحصل dilation of tubules والخلايا تصبح flattening و داخلها hyaline cast (pink secretion) وتسمى (thyroidisation)
- Chronic Inflammatory cells (lymphocytes)
- hyaline arteriosclerosis may be caused by hypertension

..

#GROSS

#Diagnosis 👉🏻 Chronic pyelonephritis

#The_blue_arrows
Irregular in the surface and atrophic kidney

#GROSS

#Diagnosis 👉🏻 Chronic pyelonephritis

#The_black_arrow
Fibrosis
Brown to white in the color

#MICROSCOPIC

#Diagnosis 👉🏻 Chronic pyelonephritis

#The_black_arrows
Thyroidisation

#MICROSCOPIC

#Diagnosis 👉🏻 Chronic pyelonephritis

#The_black_arrows
Atrophied tubules

#MICROSCOPIC
CHRONIC PYELONEPHRITIS

#صورة_لتوضيح Atrophied tubules

#MICROSCOPIC
#Diagnosis 👉🏻 Chronic pyelonephritis

#The_black_arrows
Atrophied tubules

#GROSS
#Diagnosis 👉🏻 cystitis


#The_features
Signs of inflammation
- Hyperemia (Erythema)
- Thickening
- swelling

Route of infection
From descending as from pelvis & ureter

#MICROSCOPIC

#Diagnosis 👉🏻 cystitis


#The_black_arrow
Transitional epithelium

#The_blue_arrows
Inflammatory cells

#The_features
Increase inflammatory cells in submucosa
Neutrophils (acute cystitis)
Lymphocytes (chronic cystitis)

The Causes
Bacterial
Or Schtosoma hematobium

#MICROSCOPIC

#Diagnosis 👉🏻 Eosinophilic cystitis (Schistosomiasis)


#The_blue_arrow
Transitional epithelium

#The_black_arrows
Schistosoma eggs

#The_yellow_arrows
Eosinophilic lesion

Schistosoma eggs in muscles layer

Schistosoma eggs in urine

#The_black_arrows
RBCs
Due to hematuria

BRUNN'S NESTS
benign bladder lesions similar in appearance

تحدث هذه الحالة بسبب irritation للـ transitional epithelium التي تسببه Schistosoma
وبسبب irritation بيحصل hyperplasia of transitional فلما تعمل المثانه contraction و hyperplasia قده thick بتضغط على transitional  وتدخله الى submucosa  مكونه nests


هذا Neste يلي تكونت فيما بعد يحصل انه الدم ما يوصلش للـ central تبعها فتموت الخلايا مكونه فراغ يمسى cystica
Cystica: spaces filled with clear fluid lined by flattened urothelium
وهذه الحالة تسمى CYSTITES CYSTICA


او Nests هذه الخلايا تبعها يلي في central تتمايز إلى cuboidal or columnar cell (columnar metaplasia) وتكون gland like lumens
وتسمى CYSTITES GLANDULARIS


THE CAUSES
- Schistosoma
- Cancer
..

#MICROSCOPIC

#Diagnosis 👉🏻 brunn's nests

#The_yellow_arrows
Nests

#MICROSCOPIC

#Diagnosis 👉🏻 cystitis cystica

#The_black_arrows
Cystica

#MICROSCOPIC

#Diagnosis 👉🏻 cystitis glandularis

#The_black_arrows
Columnar metaplasia

#GROSS

#Diagnosis 👉🏻 kidney infrect


THE CAUSE
Necrosis due to Ischemia
هذه الـ ischemia حصلت بسبب Thromboemboli
ونوع الـ necrosis هو coagulative

#The_features
Necrosis like wedge shaped (the apex towards medulla) , pale in color and ringed by intense

#MICROSCOPIC

#Diagnosis 👉🏻 kidney infrect

#The_black_area
Necrosis

هنا ظهرة eosinophilic بسبب انه الوسط تحول إلى قاعدي نتجة denaturation of protein

A
#Diagnosis 👉🏻 Normal kidney

#The_blue_arrows
Normal glomerulus and tubules


B
#Diagnosis 👉🏻 kidney infrect

#The_black_arrows
Necrosis glomerulus and tubules (coagulative)

بسبب necrosis الـ nucleus absent
And tubules filled with fibrin debris