IPLab:Lab 2:Metaplasia

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Clinical Summary[edit]

This 30-year-old black male was born with a meningocele which was repaired in childhood. Despite repair of the meningocele, this patient continued to have a neurogenic bladder.

Six months previous to this admission, the patient passed a single renal calculus but intravenous pyelogram (IVP) showed left nephrolithiasis (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 hesitancy and urgency and suffered occasional urinary tract infections.

On this admission, a culture of the patient's urine specimen grew Gram-negative bacilli (Proteus species). Cystoscopy showed heavy trabeculation of the bladder with early diverticula 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.


Virtual Microscopy[edit]

Kidney: Metaplasia[edit]

Normal Kidney[edit]

Study Questions[edit]

Additional Resources[edit]


Journal Articles[edit]


A meningocele is the herniation of the CSF-filled meningeal sac through a vertebral defect.

Neurogenic bladder is a dysfunction of the bladder caused by a nervous system lesion.

A renal calculus is a "kidney stone."

The 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.

Nephrolithiasis is the presence of a urinary calculus within the kidney.

Hesitancy is the inability to begin the stream of urine.

Urgency is the experience of an intense and immediate desire to void.

Cystoscopy is the direct visual examination of the bladder via a cystoscope.

A bladder diverticulum is an out-pouching of the bladder wall, usually caused by chronic urethral obstruction.