Selected Photomicrographs

A. Kidney cortex and kidney medulla (Figure 19-3)

Figure 19-3. (A) Light micrograph of kidney cortex. A renal glomerulus (a capillary network) is shown along with the parietal layer of Bowman's capsule (arrow) and visceral layer of Bowman's capsule (podocytes; double arrows). PCT - proximal convoluted tubules. (IS) Light micrograph of kidney medulla. Cross-sections of various kidney tubules and vasa rectae are shown. CD = collecting duct; ST = proximal or distal straight tubule; t - descending of ascending thin loop of Henle; vr = vasa rectae.

B. Podocytes and Na+-K+-ATPase localization (Figure 19-4)

Figure 19-4. (A) Electron micrograph of the renal glomerulus. A podocyte (P) with its foot processes is adjacent to the basement lamina. Note the filtration slits and rhe pore within the endothelial cell of the renal capillary. (Courtesy of D. Friend, Brigham and Womens Hospital, Bosron, Massachusetts.) (B) Scanning electron micrograph of the renal glomerulus. A podocyte (P) and foot processes (F) are shown. [Reprinted with permission from Andrews P: Morphological alterations of the glomerular (visceral) epithelium in response to pathological and experimental situations. J Electron Microsc Tech 9(2): 115, 1988. © 1988, John Wiley &. Sons, Inc. Reprinted by permission of Wiley-Liss, Inc., a division of John Wiley & Sons, Inc.] (C) Electron micrograph of a kidney tubule immunocytochemically stained with a monoclonal antibody against the alpha subunit of Na+-K + -ATPase. Basal infoldings (arrows) stain (dark black) immunocytochemically positive for Na + -K + -ATPase. L = lumen. [Reprinted with permission from Kashgarian M: Identification of molecules in the kidney utilizing immunocytochemistry. J Electron Microsc Tech 9(3):265, 1988. © 1988, John Wiley & Sons, Inc. Reprinted by permission of Wiley-Liss, Inc., a division of John Wiley & Sons, Inc.]

Figure 19-4. (A) Electron micrograph of the renal glomerulus. A podocyte (P) with its foot processes is adjacent to the basement lamina. Note the filtration slits and rhe pore within the endothelial cell of the renal capillary. (Courtesy of D. Friend, Brigham and Womens Hospital, Bosron, Massachusetts.) (B) Scanning electron micrograph of the renal glomerulus. A podocyte (P) and foot processes (F) are shown. [Reprinted with permission from Andrews P: Morphological alterations of the glomerular (visceral) epithelium in response to pathological and experimental situations. J Electron Microsc Tech 9(2): 115, 1988. © 1988, John Wiley &. Sons, Inc. Reprinted by permission of Wiley-Liss, Inc., a division of John Wiley & Sons, Inc.] (C) Electron micrograph of a kidney tubule immunocytochemically stained with a monoclonal antibody against the alpha subunit of Na+-K + -ATPase. Basal infoldings (arrows) stain (dark black) immunocytochemically positive for Na + -K + -ATPase. L = lumen. [Reprinted with permission from Kashgarian M: Identification of molecules in the kidney utilizing immunocytochemistry. J Electron Microsc Tech 9(3):265, 1988. © 1988, John Wiley & Sons, Inc. Reprinted by permission of Wiley-Liss, Inc., a division of John Wiley & Sons, Inc.]

Figure 19-5. Light micrograph of the juxtaglomerular apparatus. A renal glomerulus (KG) and afferent arteriole (aa) arc shown along with the juxtaglomerular cells (jg), which secrete renin. A distal straight tubule (DST) can be observed with associated macula densa cells (md),which monitor a decrease in the concentration of sodium ions in the DST tubular fluid. A proximal convoluted tubule (PCT) also is shown.

C. Juxtaglomerular apparatus (Figure 19-5)

Figure 19-5. Light micrograph of the juxtaglomerular apparatus. A renal glomerulus (KG) and afferent arteriole (aa) arc shown along with the juxtaglomerular cells (jg), which secrete renin. A distal straight tubule (DST) can be observed with associated macula densa cells (md),which monitor a decrease in the concentration of sodium ions in the DST tubular fluid. A proximal convoluted tubule (PCT) also is shown.

D. Wilms tumor and adult polycystic kidney disease (Figure 19-6)

D. Wilms tumor and adult polycystic kidney disease (Figure 19-6)

Figure 19-6. (A) Light micrograph of Wilms tumor. Wilms tumor is a very common primary renal tumor in children. Ir is characterized histologically by recognizable attempts to recapitulate embryonic development of the kidney. In this regard, the following three components are seen: (1) metanephric blastema elements (bias) consisting of clumps of small, tightly-packed embryonic cells, (2) stromal elements (str), and (3) epithelial elements generally in the form of abortive attempts at forming tubules (t) or glomeruli. (B) Light micrograph of adult polycystic kidney disease (APKD). Large, fluid cysts (cys) are found throughout the substance of the kidney. In between the cysts, some functioning nephrons can be found. APKD is an autosomal-dominant disease with 100% penetrance, which means that all individuals with the abnormal gene will express the disease. APKD is associated in approximately 10%—30% of the patients with a berry aneurysm and subarachnoid hemorrhage. RG = renal glomerulus; t = renal tubules. (Reprinted with permission from East Carolina University, School of Medicine, Department of Pathology slide collection.)

Figure 19-6. (A) Light micrograph of Wilms tumor. Wilms tumor is a very common primary renal tumor in children. Ir is characterized histologically by recognizable attempts to recapitulate embryonic development of the kidney. In this regard, the following three components are seen: (1) metanephric blastema elements (bias) consisting of clumps of small, tightly-packed embryonic cells, (2) stromal elements (str), and (3) epithelial elements generally in the form of abortive attempts at forming tubules (t) or glomeruli. (B) Light micrograph of adult polycystic kidney disease (APKD). Large, fluid cysts (cys) are found throughout the substance of the kidney. In between the cysts, some functioning nephrons can be found. APKD is an autosomal-dominant disease with 100% penetrance, which means that all individuals with the abnormal gene will express the disease. APKD is associated in approximately 10%—30% of the patients with a berry aneurysm and subarachnoid hemorrhage. RG = renal glomerulus; t = renal tubules. (Reprinted with permission from East Carolina University, School of Medicine, Department of Pathology slide collection.)

E. Goodpasture disease and malignant nephrosclerosis (Figure 19-7)

Figure 19-7. (A) Light micrograph of Goodpasture disease. One of the characteristics of Goodpasture disease is the presence of a rapidly progressive (crescentic) glomerulonephritis (RPGN). The RPGN associated with Goodpasture disease is a consequence of basement membrane antibodies. This micrograph shows a renal glomerulus (RG) with a distinctive fibrous crescent (cr; dotted line) due to a proliferation of the parietal layer of Bowman's capsule. (B) Light micrograph of malignant nephrosclerosis. Malignant nephrosclerosis is associated with the malignant phase of hypertension. Interlobular arteries and arterioles within the kidney show an inti-mal thickening due to a proliferation of smooth muscle cells and a concentric layering of collagen. This is called onion skinning or hyperplastic arteriolitis (arrow). RG = renal glomerulus; t = renal tubules. (Reprinted with permission from East Carolina University, School of Medicine, Department of Pathology slide collection.)

E. Goodpasture disease and malignant nephrosclerosis (Figure 19-7)

Figure 19-7. (A) Light micrograph of Goodpasture disease. One of the characteristics of Goodpasture disease is the presence of a rapidly progressive (crescentic) glomerulonephritis (RPGN). The RPGN associated with Goodpasture disease is a consequence of basement membrane antibodies. This micrograph shows a renal glomerulus (RG) with a distinctive fibrous crescent (cr; dotted line) due to a proliferation of the parietal layer of Bowman's capsule. (B) Light micrograph of malignant nephrosclerosis. Malignant nephrosclerosis is associated with the malignant phase of hypertension. Interlobular arteries and arterioles within the kidney show an inti-mal thickening due to a proliferation of smooth muscle cells and a concentric layering of collagen. This is called onion skinning or hyperplastic arteriolitis (arrow). RG = renal glomerulus; t = renal tubules. (Reprinted with permission from East Carolina University, School of Medicine, Department of Pathology slide collection.)

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