Download to read offline
Renal system -DOAP pathology ppt class.ppt
- 1.
- 2. Objectives CYSTIC DISEASESOF KIDNEY WILMS TUMOR RENAL CELL CARCINOMA
- 3. CYSTIC DISEASES OFKIDNEY Cystic diseases of the kidney are heterogeneous and comprises of hereditary, developmental and acquired disorders
- 4.
- 5. ADPKD ARPKD INCIDENCE 1:400to 1:1000 1:10000 to 1:40000 INVOLVED GENE(S) PKD 1 on chr 16 PKD 2 on chr 4 PKHD 1 on chr 6 PROTEIN DEFECTS Polycystin-1 Polycystin-2 Fibrocystin HISTOLOGIC APPEARANCE Haphazardly arranged, cystic dilation of all parts of the involved nephron with normal renal parenchyma interspersed Diffuse cystic dilation of the collecting ducts with the long axis of the cyst perpendicular to the capsule AGE AT SYMPTOM ONSET Middle-aged adulthood Infancy COMPLICATIONS Renal failure Rupture of berry aneurysms In utero foetal demise Neonatal respiratory distress Renal failure Liver failure
- 6.
- 7.
- 8. CLINICAL FEATURES Asymptomaticuntil presence of renal insufficiency Haematuria Flank pain UTI Renal stones Hypertension Hepatic fibrosis
- 9. POLYSYSTIC KIDNEY DISEASE Kidneyis markedly enlarged. 1. Outer surface bosselated 2. Cut surface : Multiple cysts of varying sizes seen throughout the kidney parenchyma
- 10. POLYCYSTIC KIDNEY Cystsmaybe filled with clear serous fluid or turbid haemorrhagic fluid Enlarging cysts may encroach on the pelvis and calyces to produce pressure defects
- 11. COMPLICATIONS Chronic RenalFailure Death in infancy or childhood Dialysis
- 12.
- 13. It isalso known as nephroblastoma. Most common primary renal tumor of childhood. . WILMS TUMOR
- 14. Pathogenesis and genetics Associated with increased risk with 3 syndromes: 1.WAGR syndrome- Wilms tumour, aniridia, genitourinary anomalies and intellectual disability. 33% risk of development of tumour 2.Denys-Drash syndrome- Gonadal dysgenesis, early onset nephropathy(renal failure) 3. Beckwith-Weidemann syndrome- organomegaly, macroglossia, hemihypertrophy, omphalocele and adrenal cytomegaly
- 16. GROSS Large, solitary Well circumscribed mass 10% cases- bilateral
- 17.
- 18. MICROSCOPY 3 components: -Blastemal-sheets of blue cells -Epithelial- abortive tubules or glomeruli -Stromal- fibroblastic or myxoid in nature
- 20. RCC accountfor 85% of renal cancers in adults. Occurs most often in older individuals, usually in 6th and 7th decades of life. Arises from tubular epithelium. May arise in any portion of kidney, more commonly in poles. RENAL CELL CARCINOMA
- 21. Types of RCC: 1.Clearcell carcinoma (most common) 2.Papillary carcinoma 3.Chromophobe renal carcinoma 4.Collecting duct (Bellini duct) carcinoma RENAL CELL CARCINOMA
- 22. GROSS • From proximaltubular epithelium • Usually solitary unilateral • Well-defined • Variegated reddish- yellow spherical masses • Yellow- lipid accumulation in tumor cells • Red- hemorrhage
- 23. GROSS Tumor occupyingthe upper pole of the kidney. Cut section – variegated with yellow, brown tumor tissue and areas of hemorrhage.
- 24. MICROSCOPY Tumor tissue:Tubular pattern with round or polygonal cells having clear cytoplasm and nuclei of varying sizes. The cell groups are separated by thin septa with prominent blood vessels.
- 26.