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Difference between revisions of "Kidney"
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[[Image:Kidney_Cross_Section.png|thumb|right|A drawing of the kidney in cross section. (WC/Holly Fischer)]] | |||
The '''kidney''' is an important organ in the abdomen that does the following: | The '''kidney''' is an important organ in the abdomen that does the following: | ||
*Water balance & blood pressure regulation, | *Water balance & blood pressure regulation, | ||
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*Removes toxins/cleans the blood, and | *Removes toxins/cleans the blood, and | ||
*Produces hormones (e.g. erythropoietin). | *Produces hormones (e.g. erythropoietin). | ||
=Normal= | |||
===Sign out=== | |||
====Missed biopsy==== | |||
<pre> | |||
KIDNEY, RIGHT, BIOPSY: | |||
- SCANT BENIGN ADIPOSE TISSUE AND A FEW SMALL BLOOD VESSELS. | |||
- NO RENAL PARENCHYMA IS IDENTIFIED. | |||
- NO EVIDENCE OF MALIGNANCY. | |||
COMMENT: | |||
The indication (mass lesion) and clinical suspicion is noted. The tissue | |||
sample may not be representative of the lesions seen radiologically. | |||
Clinical correlation is required. | |||
</pre> | |||
=====Micro===== | |||
The sections show benign adipose tissue with a few small blood vessels. The core length (at microscopy) is approximately 9 millimetres. No renal parenchyma is identified. No nuclear atypia is identified. No significant amount of smooth muscle is apparent. | |||
=Tumours= | =Tumours= | ||
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This article cover the common renal tumours: | This article cover the common renal tumours: | ||
*[[Renal cell carcinoma]. | *[[Renal cell carcinoma]]. | ||
*[[Renal oncocytoma|Oncocytoma]]. | *[[Renal oncocytoma|Oncocytoma]]. | ||
*Most other tumours... except ''urothelial tumours'' are dealt with in the ''[[urothelium]]'' article. | *Most other tumours... except ''urothelial tumours'' are dealt with in the ''[[urothelium]]'' article. | ||
Pediatric tumours are covered in ''[[pediatric | Pediatric tumours are covered in ''[[pediatric kidney tumours]]''. | ||
=Medical kidney diseases= | =Medical kidney diseases= | ||
{{main|Medical kidney diseases}} | {{main|Medical kidney diseases}} | ||
This is almost a specialty for itself. Lots of interaction with nephrologists. | This is almost a specialty for itself. Lots of interaction with nephrologists. Cystic renal disease is dealt with in a separate article called ''[[cystic kidney diseases]]''. | ||
=Other= | |||
==Renal segmental hypoplasia== | |||
{{Main|Renal segmental hypoplasia}} | |||
=Developmental= | =Developmental= | ||
==Horseshoe kidney== | |||
===General=== | |||
*Anatomical variant. | |||
*Prevalence ~1 in 500.<ref name=Ref_Klatt233>{{Ref Klatt|233}}</ref> | |||
===Gross=== | |||
*The inferior poles of the kidneys are joined with one another - have the shape of a horseshoe. | |||
Image: | |||
*[http://library.med.utah.edu/WebPath/RENAHTML/RENAL004.html Horseshoe kidney (utah.edu)]. | |||
==Multicystic renal dysplasia== | ==Multicystic renal dysplasia== | ||
*Abbreviated ''MRD''. | |||
===General=== | ===General=== | ||
*Most common cause of abdominal mass in newborns.<ref name=emed_mrd/> | *Most common cause of abdominal mass in newborns.<ref name=emed_mrd/> | ||
*Subtype of renal dysplasia.<ref name=emed_mrd>URL: [http://emedicine.medscape.com/article/982560-overview http://emedicine.medscape.com/article/982560-overview]. Accessed on: 4 January 2012.</ref> | *Subtype of renal dysplasia.<ref name=emed_mrd>URL: [http://emedicine.medscape.com/article/982560-overview http://emedicine.medscape.com/article/982560-overview]. Accessed on: 4 January 2012.</ref> | ||
*May be unilateral or involve only part of a kidney.<ref name=Ref_Klatt237>{{Ref Klatt|237}}</ref> | |||
===Gross=== | |||
*Kidney has multiple large cysts or differing sizes. | |||
DDx: | |||
*[[ARPKD]] - has less variability of cyst size. | |||
Images: | |||
*[http://library.med.utah.edu/WebPath/RENAHTML/RENAL043.html MRD (utah.edu)]. | |||
*[http://radiology.uchc.edu/eAtlas/GU/551.htm MRD (radiology.uchc.edu)]. | |||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features:<ref name=Ref_Klatt237>{{Ref Klatt|237}}</ref> | ||
* | *Cystic spaces. | ||
* | *Fibrous stroma. | ||
*Islands of cartilage. | |||
Image: | |||
*[http://library.med.utah.edu/WebPath/TUTORIAL/RENCYST/RCYST012.html RMD (utah.edu)]. | |||
==Renal medullary dysplasia== | ==Renal medullary dysplasia== | ||
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**[[Beckwith-Wiedemann syndrome]].<ref name=pmid17172498>{{Cite journal | last1 = Dotto | first1 = J. | last2 = Reyes-Múgica | first2 = M. | title = Renal medullary dysplasia is diagnostic of Beckwith-Wiedemann syndrome. | journal = Int J Surg Pathol | volume = 15 | issue = 1 | pages = 60-1 | month = Jan | year = 2007 | doi = 10.1177/1066896906295685 | PMID = 17172498 }}</ref> | **[[Beckwith-Wiedemann syndrome]].<ref name=pmid17172498>{{Cite journal | last1 = Dotto | first1 = J. | last2 = Reyes-Múgica | first2 = M. | title = Renal medullary dysplasia is diagnostic of Beckwith-Wiedemann syndrome. | journal = Int J Surg Pathol | volume = 15 | issue = 1 | pages = 60-1 | month = Jan | year = 2007 | doi = 10.1177/1066896906295685 | PMID = 17172498 }}</ref> | ||
**[[Placenta|Placental]] insufficiency.<ref name=pmid19297558>{{Cite journal | last1 = Sparrow | first1 = DB. | last2 = Boyle | first2 = SC. | last3 = Sams | first3 = RS. | last4 = Mazuruk | first4 = B. | last5 = Zhang | first5 = L. | last6 = Moeckel | first6 = GW. | last7 = Dunwoodie | first7 = SL. | last8 = de Caestecker | first8 = MP. | title = Placental insufficiency associated with loss of Cited1 causes renal medullary dysplasia. | journal = J Am Soc Nephrol | volume = 20 | issue = 4 | pages = 777-86 | month = Apr | year = 2009 | doi = 10.1681/ASN.2008050547 | PMID = 19297558 }}</ref> | **[[Placenta|Placental]] insufficiency.<ref name=pmid19297558>{{Cite journal | last1 = Sparrow | first1 = DB. | last2 = Boyle | first2 = SC. | last3 = Sams | first3 = RS. | last4 = Mazuruk | first4 = B. | last5 = Zhang | first5 = L. | last6 = Moeckel | first6 = GW. | last7 = Dunwoodie | first7 = SL. | last8 = de Caestecker | first8 = MP. | title = Placental insufficiency associated with loss of Cited1 causes renal medullary dysplasia. | journal = J Am Soc Nephrol | volume = 20 | issue = 4 | pages = 777-86 | month = Apr | year = 2009 | doi = 10.1681/ASN.2008050547 | PMID = 19297558 }}</ref> | ||
===Microscopic=== | |||
Features:<ref name=pmid17172498/> | |||
*Widely spaced tubules in the medulla of the kidney. | |||
=See also= | =See also= | ||