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== Clinical Summary ==
This 64-year-old white man had a history of hypertension, adult-onset diabetes, gouty arthritis, chronic obstructive pulmonary disease (COPD), and chronic anemia. The patient was in end-stage renal failure due to polycystic kidney disease and he required renal dialysis. His mother and a brother both died from renal complications.
== Images ==
<gallery heights="250px" widths="250px">
File:IPLab5PolycysticKidney1IPLab5PolycysticKidney1b.jpg|This is a gross photograph of the kidneys from this case. Note that both kidneys contain multiple large cysts (arrows). File:IPLab5PolycysticKidney2IPLab5PolycysticKidney2b.jpg|This is a gross photograph of one of the kidneys from this case next to a normal kidney. This photograph demonstrates how big these polycystic kidneys are compared to a normal kidney. File:IPLab5PolycysticKidney3IPLab5PolycysticKidney3b.jpg|This is a gross photograph of a cut section from one of these polycystic kidneys. Note that the renal parenchyma is almost completely replaced by cystic structures.
File:IPLab5PolycysticKidney4.jpg|This is a low-power photomicrograph of an H&E-stained section from this polycystic kidney. Note the large cystic structures (1), the few residual glomeruli (2), and the fibrous connective tissue throughout this section.
File:IPLab5PolycysticKidney5.jpg|This is another low-power photomicrograph of an H&E-stained section from this polycystic kidney. Again note the large cystic structures (arrows)and the fibrous connective tissue throughout this section.
File:IPLab5PolycysticKidney6.jpg|This is a higher-power photomicrograph of polycystic kidney showing the edge of a large cyst (1). In this section there are numerous tubules and dilated collecting ducts (2) that are filled with the same red proteinaceous material as the larger cysts.
File:IPLab5PolycysticKidney7.jpg|This high-power photomicrograph shows abnormal glomeruli (arrows) and some tubules.
File:IPLab5PolycysticKidney8IPLab5PolycysticKidney8b.jpg|This is a gross photograph of the liver from this patient. Multiple cysts can be seen on the surface of this liver (arrows).
File:IPLab5PolycysticKidney9.jpg|This photomicrograph of liver demonstrates the histologic appearance of these cysts.
File:IPLab5PolycysticKidney10.jpg|This is another photomicrograph of liver demonstrating the histologic appearance of these cysts. These cystic structures are associated with the biliary tree.
File:IPLab5PolycysticKidney11.jpg|This is a higher-power photomicrograph of liver cyst. These cystic structures are lined by biliary epithelium.
</gallery>
== Virtual Microscopy ==
<peir-vm>IPLab5PolycysticKidney</peir-vm>
== Study Questions ==
* <spoiler text="What is the significance of history of hypertension and uremic pericarditis in this patient?">People with polycystic kidney disease often develop hypertension, as do many patients with renal disease. Uremic pericarditis often occurs in people with kidney failure induced uremia.</spoiler>
* <spoiler text="What are some of the other congenital anomalies that can be seen in people with polycystic kidney disease?">Asymptomatic polycystic liver disease is seen in 40% of these patients. Cysts can also occur, albeit infrequently, in the spleen, pancreas and lungs. These people also have a 10% to 30% incidence of berry aneurysms in the circle of Willis.</spoiler>
== Additional Resources ==
=== Reference ===
* [http://emedicine.medscape.com/article/244907-overview eMedicine Medical Library: Polycystic Kidney Disease]
* [http://emedicine.medscape.com/article/453831-overview eMedicine Medical Library: Cystic Diseases of the Kidney]
* [http://www.merckmanuals.com/professional/genitourinary_disorders/cystic_kidney_disease/overview_of_cystic_kidney_disease.html Merck Manual: Overview of Cystic Kidney Disease]
=== Journal Articles ===
* Bajwa ZH, Gupta S, Warfield CA, Steinman TI. [http://www.ncbi.nlm.nih.gov/pubmed/11703580 Pain management in polycystic kidney disease]. ''Kidney Int'' 2001 Nov;60(5):1631-44.
=== Images ===
* [{{SERVER}}/library/index.php?/tags/110-polycystic_disease PEIR Digital Library: Polycystic Kidney Disease Images]
* [http://library.med.utah.edu/WebPath/RENAHTML/RENALIDX.html#5 WebPath: Polycystic Kidney Disease]
{{IPLab 5}}
[[Category: IPLab:Lab 5]]