Renal Pathology — MCQs

Q: All are features of hypernephroma except:

Lower pole involvement. ***Lower pole involvement*** - Renal cell carcinoma (hypernephroma) characteristically shows a **predilection for the upper pole** of the kidney, occurring in approximately **70-75% of cases** [1]. - **Lower pole involvement is NOT a typical feature** and occurs less frequently. - This upper pole predilection is an important distinguishing characteristic of RCC. *Cannon ball secondaries are seen* - **Cannonball metastases** (large, round, well-circumscribed lesions) are a characteristic radiographic finding when renal cell carcinoma metastasizes to the **lungs**. - This appearance is highly suggestive of advanced renal cell carcinoma. *More common in males* - Renal cell carcinoma consistently shows a higher incidence in **males than females**, with a male-to-female ratio of approximately **2:1** [1]. - This **gender predisposition** is well-established in epidemiological studies. *May invade renal vein* - **Renal vein invasion** is a classic and critical feature of renal cell carcinoma, which can extend into the **inferior vena cava** [1]. - This venous invasion is a significant factor in **staging and prognosis** [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 959-961.

Q: Mesangial deposition of electron-dense substance is seen in?

IgA nephropathy. ***IgA nephropathy*** - Characterized by **mesangial deposition** of IgA-dominant immune complexes, leading to **electron-dense substance** visible on electron microscopy [1]. - Often presents with **hematuria** and **episodic proteinuria**, frequently following infections. *Post streptococcal glomerulonephritis* - Typically involves **subepithelial immune complex deposition**, resulting in **humps on the glomerular basement membrane** rather than mesangial deposits. - Associated with **hematuria** and **edema**, occurring after a streptococcal infection. *Membranous nephropathy* - Characterized by **subepithelial immune complex deposits** along the capillary walls causing a **thickened membrane**, not mesangial deposits. - Presents with **nephrotic syndrome**, features such as heavy proteinuria, edema, and hyperlipidemia. *Minimal change disease* - Primarily involves **loss of podocyte foot processes** and does not have significant deposits observable on microscopy, including electron-dense substance [1]. - Commonly seen in **children**, presenting with **nephrotic syndrome** and good response to steroids [1]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Kidney, pp. 927-928.

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Congenital Anomalies of the Kidney

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Glomerular Diseases

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Tubular and Interstitial Diseases

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Vascular Diseases of the Kidney

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Cystic Diseases of the Kidney

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Urinary Tract Obstruction and Stones

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Renal Tumors

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Kidney in Systemic Diseases

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Renal Transplantation Pathology

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Urinary Tract Infections

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