#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

THE FIRST LAB DONE  ✓✓

العلامات المميزة لكل مرض في الرينال..

NEPHROTIC SYNDROME
𖣔 Caused
- Masive Proteinuria
- hyperlipidemia
- severe edema (anasarca)

𖣔 Cause
𖦹 Primary
• Membranous nephropathy
• Manimal changes disease
• focal segmental glomerulosclerosis
• Membranoproliferative glomerulonephritis

𖦹 Secondary
- diabetic nephropathy
- Immunologic disease


•°•°•°•°•°•°•°•°•°•°•°•°•°•°•°•°•°•°•°•°

MINIMAL CHANGE DISEASES
( Lipoid nephrosis )

✫ Definition
Idiopathic glomerular disease that causes nephrotic syndrome

Most common type of nephrotic syndrome in children


✫ Gross description
Enlarged, waxy yellow cortex due to lipid accumulation in proximal tubules

✫Microscopic description
- Glomerulus normal
- No tubular atrophy
- No interstitial scarring
- Lipid droplets deposetion in tubules
By Periodic acid - methenamin sliver stain (Jones stain)
- BM & Mesangial matrix ➪ black
- epithelium cell & mesangial cell ➪ grey pink


✫Electron microscopy description
- foot process of podocyte effacement
- Normal fenestrated
- Normal BM in thickness

✫Immunofluorescence
Negative

..

#MICROSCOPIC

#Diagnosis 👉🏻 Minimal change disease

#The_blue_arrows
Fat droplets in tubules

#The_black_arrows
lipid laden macrophages in the interstitium

#ELECTRON_MICROSCOP

#Diagnosis 👉🏻 Minimal change disease
OR
Focal segmental glomerulonephritis

#The_black_arrow
Foot processes effacement

#The_blue_arrow
BM

#The_red_arrow
Fenestrated endothelium

#The_yellow_arrow
Electron dense RBCs