IPLab:Lab 2:Metaplasia

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Contents

Clinical Summary

This 30-year-old black male was born with a meningoceleA meningocele is the herniation of the CSF-filled meningeal sac through a vertebral defect. which was repaired in childhood. Despite repair of the meningoceleA meningocele is the herniation of the CSF-filled meningeal sac through a vertebral defect., this patient continued to have a neurogenic bladderNeurogenic bladder is a dysfunction of the bladder caused by a nervous system lesion..

Six months previous to this admission, the patient passed a single renal calculusA renal calculus is a "kidney stone." but intravenous pyelogramThe patient is given an intravenous injection of contrast medium that rapidly enters the urine. Radiographs are then taken to show the passage of the contrast-containing urine through the pelvicaliceal system. (IVP) showed left nephrolithiasisNephrolithiasis is the presence of a urinary calculus within the kidney. (a 1 cm stone in the lower lobe). For 6 months the patient had to be catheterized each day for 6 hours. However, he continued to complain of hesitancyHesitancy is the inability to begin the stream of urine. and urgencyUrgency is the experience of an intense and immediate desire to void. and suffered occasional urinary tract infections.

On this admission, a culture of the patient's urine specimen grew Gram-negative bacilli (Proteus species). CystoscopyCystoscopy is the direct visual examination of the bladder via a cystoscope. showed heavy trabeculation of the bladder with early diverticulaA bladder diverticulum is an out-pouching of the bladder wall, usually caused by chronic urethral obstruction. and the left ureteral orifice showed squamous metaplasia. The lower pole of the left kidney was removed surgically, following which the patient recovered and was discharged on antibiotics.

Images

Virtual Microscopy

Kidney: Metaplasia

Normal Kidney

Study Questions


Additional Resources

Reference

Journal Articles

Images