Stephen M. Bonsib Atlas of Medical Renal Pathology 123 Atlas of Anatomic Pathology Series Editor Liang Cheng For further volumes: http://www.springer.com/series/10144 Stephen M. B onsib Atlas of Medical Renal Pathology Stephen M. Bonsib , MD Nephropath Little Rock, AR USA ISBN 978-1-4614-7149-3 ISBN 978-1-4614-7150-9 (eBook) DOI 10.1007/978-1-4614-7150-9 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2013937592 © Springer Science+Business Media New York 2013 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, speci fi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on micro fi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. 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While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com) We are the product of our intrinsic abilities modulated by extrinsic in fl uences. I was fortunate to have parents, Patricia and John Bonsib, whose lives exempli fi ed a strong work ethic and who epitomized the philosophy that anything worth doing is worth doing well. During my training, I was also blessed with excellent mentors who demanded attention to detail and possessed traditional anatomic pathology skills, such as careful observation, meticulous anatomic dissections, optimum fi xation techniques, and quality photographic composition. Of these mentors, I speci fi cally acknowledge Jay Bernstein, MD, renowned pediatric nephropathologist, whose in fl uence early in my career provided a nephropathology framework for me to strive to complete. The Jay Bernstein Consultative Collection was used heavily in this atlas, an enduring tribute to his enormous contributions to the fi eld. Last, and most importantly, I wish to acknowledge my wife, Chris, my constant companion, best friend, and biggest supporter, whose affection and devotion nurtured my evolution as a person and as a pathologist. The many images in this atlas are the product of a career devoted to the identi fi cation, preparation, and photographic documentation of classic and unusual gross specimens and microscopic fi ndings. I hope this glimpse into the vast and wondrous complexity, and esthetic beauty, of renal diseases stimulates a thirst in others to expand the universe of our knowledge of the kidney. However, despite the captivating elegance of the many intricate mechanistic pathways that culminate in the fi ndings illustrated in this text, we must remember that the human toll of these diseases is daunting. Series Preface One Picture is Worth Ten Thousand Words – Frederick Barnard, 1927 Remarkable progress has been made in anatomic and surgical pathology during the last 10 years. The ability of surgical pathologists to reach a de fi nite diagnosis is now enhanced by immunohistochemical and molecular techniques. Many new clinically important histopatho- logic entities and variants have been described using these techniques. Established diagnostic entities are more fully de fi ned for virtually every organ system. The emergence of personalized medicine has also created a paradigm shift in surgical pathology. Both promptness and preci- sion are required of modern pathologists. Newer diagnostic tests in anatomic pathology, how- ever, cannot bene fi t the patient unless the pathologist recognizes the lesion and requests the necessary special studies. An up-to-date Atlas encompassing the full spectrum of benign and malignant lesions, their variants, and evidence-based diagnostic criteria for each organ system is needed. This Atlas is not intended as a comprehensive source of detailed clinical information concerning the entities shown. Clinical and therapeutic guidelines are served admirably by a large number of excellent textbooks. This Atlas, however, is intended as a “ fir st knowledge base” in the quest for de fi nitive and ef fi cient diagnosis of both usual and unusual diseases. The Atlas of Anatomic Pathology is presented to the reader as a quick reference guide for diagnosis and classi fi cation of benign, congenital, in fl ammatory, nonneoplastic, and neoplastic lesions organized by organ systems. Normal and variations of “normal” histology are illus- trated for each organ. The Atlas focuses on visual diagnostic criteria and differential diagnosis. The organization is intended to provide quick access to images and con fi rmatory tests for each speci fi c organ or site. The Atlas adopts the well-known and widely accepted terminology, nomenclature, classi fi cation schemes, and staging algorithms. This book Series is intended chie fl y for use by pathologists in training and practicing surgi- cal pathologists in their daily practice. It is also a useful resource for medical students, cyto- technologists, pathologist assistants, and other medical professionals with special interest in anatomic pathology. We hope that our trainees, students, and readers at all levels of expertise will learn, understand, and gain insight into the pathophysiology of disease processes through this comprehensive resource. Macroscopic and histological images are aesthetically pleasing in many ways. We hope that the new Series will serve as a virtual pathology museum for the edi fi cation of our readers. Liang Cheng, MD vii Preface The kidney is an organ with complex organogenesis, susceptible to numerous misadventures in development and exposed to a diverse array of insults of hematogenous and lower urinary tract origin. A tlas of Medical Renal Pathology provides an overview of the development and macroscopic and microscopic features of the normal kidney. This is followed by a comprehen- sive survey of developmental and cystic kidney, tubulointerstitial, and vascular diseases. Emphasis is placed on gross diagnostic fi ndings with detailed histologic correlates. In addition, the histologic, immunohistochemical, immuno fl uorescent, and ultrastructural features of renal transplantation pathology and the major glomerular diseases are presented. This compendium of nonneoplastic kidney diseases illustrates the vast majority of diseases you will likely encounter in surgical and autopsy pathology. However, no text can hope to be truly compre- hensive, especially with an organ as complex as the kidney. Little Rock, AR, USA Stephen M. Bonsib, MD ix