#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

#MICROSCOPIC

#Diagnosis 👉🏻 Acute tubular injury and necrosis (distal)

#The_black_arrows
Necrosis tubules

#The_blue_arrows
Intratubular obstruction
Due to necrosis cells


THE CAUSES
الـ necrosis حصل بسبب الـ Ischemia فالدم وصل للـ proximal فقط و ما وصلش للـ distal
فالمتضرر الان distal حصله له necrosis و Necrotic cells انتقلت الى داخل tubules وسببت Obstruction فحصل عند الشخص oliguria قد تستمر هذه الحالة او يحصل regeneration للخلايا تبع tubules بس الخلايا تكون immature فما يحصلش reabsorption بشكل المطلوب فيحصل عند الشخص polyuria

#MICROSCOPIC

#Diagnosis 👉🏻 Acute tubular injury and necrosis (proximal)

#The_black_arrow
Tubular vacuolization

#The_blue_arrow
Tubular dilation


THE CAUSES
الـ necrosis حصل بسبب الـ toxic فالدم وصل للـ proximal
فالمتضرر الان proximal حصله له necrosis و Necrotic cells انتقلت الى داخل tubules وسببت Obstruction فحصل عند الشخص oliguria قد تستمر هذه الحالة او يحصل regeneration للخلايا تبع tubules بس الخلايا تكون immature فما يحصلش reabsorption بشكل المطلوب فيحصل عند الشخص polyuria

#The_features
- Tubular dilation
- Tubular vacuolization
- destructions cells
- Absent nucleus

#MICROSCOPIC

#Diagnosis 👉🏻 Acute tubular injury and necrosis


#The_black_arrow
Regenerative tubular

#The_blue_arrow
Obstruction tubule
Filled with fibrin debris or hyaline casts

DIABETIC NEPHROPATHY
Is morphologic structural change in the kidney , and caused
- nephrotic syndrome
- pyelonephritis
- Interstitium inflammation
- papillary necrosis
- atherosclerosis 👇🏻
وهذا بسبب hyperlipidima الذي يعمله


✫Microscopic Description
- Diffuse sclerosis
- deposition of glycogen in tubules
- Interstitium inflammatory cells and fibrosis
- Thickening in the tubules , glomerular and bowman capsule BM
- mesangial matrix expansion
- Nodular lesions (kimmelstil-wilson lesions)
- Vascular hyalinosis
- Hyalinosis of afferent and efferent arterioles

#MICROSCOPIC

#Diagnosis 👉🏻 diabetic nephropathy

#The_black_arrow
Thickening in BM of bowman capsule

#The_blue_arrow
Mesangial matrix expansion

#The_white_arrow
Fibrosis

#The_yellow_arrows
Thickening in BM of tubules

#MICROSCOPIC

#Diagnosis 👉🏻 diabetic nephropathy

#The_black_arrow
Nodular lesions (kimmelstil-wilson lesions)

#The_white_arrow
Fibrosis and inflammatory cell

#MICROSCOPIC

#Diagnosis 👉🏻 diabetic nephropathy


#The_black_arrows
Thickening in BM of tubules

#The_blue_arrows
Fibrosis and inflammatory cells

#MICROSCOPIC

#Diagnosis 👉🏻 diabetic nephropathy

#The_black_arrow
Vascular hyalinosis

#The_blue_arrow
Thickening in BM of tubules

#The_yellow_arrows
Inflammatory cells and fibrosis

#MICROSCOPIC

#Diagnosis 👉🏻 diabetic nephropathy

#The_large_arrow
Hyalinosis of afferent arterioles

#The_small_arrow
Hyalinosis of efferent arterioles