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1:
Kidney - Multilocular Cyst
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Comments: This low-power scan of the glass slide nicely illustrates the small and large cysts separated by thin fibrous septa. The cysts have smooth inner surface and do not communicate with the renal pelvis.
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2:
Kidney - Multilocular Cyst
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Comments: The cysts are lined by flattened epithelium. Solid areas and nephronic elements are absent from cyst walls. Cystic nephroma should be distinguished from cystic renal cell carcinoma and cystic Wilms tumor.
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3:
Kidney - Staghorn Calculus
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Comments: A large staghorn calculus is seen obstructing the renal pelvi-calyceal system. The lower pole of the kidney shows areas of hemorrhage and necrosis with collapse of cortical areas.
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4:
Xanthogranulomatous pyelonephritis
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Comments: This gross photograph shows extensive destruction of renal parenchyma due to long-standing suppurative inflammation. The depressions seen in the lower half of the specimen were caused by a staghorn calculus which has been removed.
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5:
Xanthogranulomatous pyelonephritis
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Comments: This 25 y/o female presented with a renal mass and underwent radical nephrectomy to rule out carcinoma. The specimen revealed xanthogranulomatous pyelonephritis with a large perinephric abscess. There is a 6.0 cm cavitary lesion in the center of the kidney lined by shaggy hemorrhagic surface. It communicates with the perinephric abscess on the central lateral aspect of the specimen. Case contributed by: Liang Cheng, MD, Dept. of Pathology, Indiana University School of Medicine, Indianapolis.
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6:
Xanthogranulomatous Pyelonephritis
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Comments: The underlying pathogenetic mechanism in XGP is renal outflow obstruction (often caused by Staghorn calculi) in the setting of suppurative inflammation. Clinical presentation, radiographic features, and gross appearance of XGP may closely mimic a renal neoplasm making a correct pre-operative diagnosis difficult. Case contributed by: Liang Cheng, MD, Dept. of Pathology, Indiana University School of Medicine, Indianapolis.
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7:
Xanthogranulomatous Pyelonephritis
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Comments: Another case of XGP showing destruction of approximately 70% of the kidney. Numerous dilated calyces with yellow-brown calculi are seen. The central necrotic areas are surrounded by dense fibrosis. Case contributed by: Liang Cheng, MD, Dept. of Pathology, Indiana University School of Medicine, Indianapolis.
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