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Hemorrhagic Papillary Necrosis
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Hemorrhagic Papillary Necrosis

The dark hemorrhagic areas are renal papillae that are necrotic.
The overlying cortical tissue is relatively spared by the necrotizing process, especially in the mid lower field of the photograph.
(Description By:H. Yamase, M.D. )
(Image Contrib. by: UCHC )
Papillary Necrosis
Etiology

Papillary necrosis can be seen as a complication of chronic analgesic abuse, diabetic nephropathy, infectious pyelonephritis and sickle cell anemia.
Etiology would be that of the related disease process.
Pathogenesis

A possible mechanism is vascular ischemic injury to the renal papillae.,
Epidemiology
Papillary necrosis can be seen as a complication of chronic analgesic abuse, diabetic nephropathy, infectious pyelonephritis and sickle cell anemia.
Epidemiology would be that of the related disease process.
General Gross Description

Necrotic papillae in the acute phases could be pale and soft or hemorrhagic.
Necrotic papillae may become detached from cortical tissues and would therefore be absent.
Necrotic papillae that are sloughed may be passed in the urine as tissue fragments.
Necrotic papillae that are not detached may resolve as amorphous, fibrotic scarred tissue.
General Microscopic Description

Microscopic examination would show necrosis of the cellular elements of the papillae and hemorrhage and inflammatory reactions at the interface with viable areas.
Clinical Correlation

Papillary necrosis can be seen as a complication of chronic analgesic abuse, diabetic nephropathy, infectious pyelonephritis and sickle cell anemia.
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 973-974 and 920-921.
Primer on Kidney Disease, 1994 (National Kidney Foundation) Greenberg A. editor.
Papillary Necrosis
Synopsis by: Harold Yamase M.D. (T71120M54001)[472]
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