- 10 year old MN DSH with decreased appetite, pu/pd, moderate azotaemia, hyperphosphataemia and severe anaemia
- L kidney had a perinephric pseudocyst cranially and both kidneys measured upper end of normal 4.5cm with increased mineralisations/echogenicity and stones. There was also a small amount of free abdominal fluid.
- Cystic fluid was a transudate, cytology of kidneys pending
- How would you describe these kidneys and what do you think is causing renal failure?
- 10 year old MN DSH with decreased appetite, pu/pd, moderate azotaemia, hyperphosphataemia and severe anaemia
- L kidney had a perinephric pseudocyst cranially and both kidneys measured upper end of normal 4.5cm with increased mineralisations/echogenicity and stones. There was also a small amount of free abdominal fluid.
- Cystic fluid was a transudate, cytology of kidneys pending
- How would you describe these kidneys and what do you think is causing renal failure?
Comments
Both kidneys are enlarged,
Both kidneys are enlarged, hyperechogenic, with an irregular capsule. Renal lymphoma would be most likley with nephritis and hypercalcemic nephropathy differential diagnosis.
Cytology resulys:Preparations
Cytology resulys:
Preparations contain backgrounds of moderately dense blood and frequent clot
material with a very minimal but preserved nucleated cellularity. This is
composed of rare lone unremarkable tubular epithelial cells and just scanty
rafts or small portions of intact tubules showing highly uniform cellularity.
Leukocytes are largely in similar proportions as found in the peripheral blood
but eosinophils are subtly more prominent. Lymphocytes are mostly small
examples but eight intermediate cells with round outlines, scant amounts of
mid-basophilic agranular smooth cytoplasm, irregular nuclear outlines and
irregularly clumped chromatin with no discernible nucleoli are present. Rare
glomerular tufts are encountered and occasionally these possess adherent smooth
faint folded semi-opaque azure material.
INTERPRETATION
Please see comment
COMMENT
The epithelial populations appear unremarkable. I have scrutinised lymphocyte
populations and, whilst a few intermediate lymphocytes are found, these are
neither vacuolated or granular which would be the typical morphologic
expectation for renal lymphoma. The eosinophil prominence is subtle only but
can be paraneoplastic although a definitive causal neoplasm is not identified.
No significant inflammation, crystalline material or infectious agents are
identified. The presence of amorphous azure proteinaceous material has
anecdotally been correlated with glomerular proteinuria but better assessed by
other means.
Looks like perirenal
Looks like perirenal pseudocyst aand mauy be moving the stone