Slide 130.Chronic pyelonephritis, Kidney

A. Brief Descriptions

  1.  Pyelonephritis: an infection of the kidney which affects tubules, interstitium, and renal pelvis.

  2. Chronic pyelonephritis is a more complex disorder: bacterial infection, vesicouretheral reflux, obstruction are involved in its pathogenesis.

  3. Chronic tubulointerstitial inflammation and renal scarring are associated with pathologic involved of the calyces and pelvis.

B. Gross Findings

  1. Scars are seen overlying a blunted or deformed calyx.

C. Micro Findings

  1. In scared areas, dilated, atrophic tubules lined by atrophic epithelium and containing homogeneous eosinophilic casts likened to thyroid tissue (thyroidization), and with scant inflammation in these areas.

  2. The glomeruli show very variable changes: thickening of Bowman's capsule, fibrosis outside the capsule, collapse or solidification of tuft, sclerosis or hyalinosis of tuft , proliferative change and necrosis.

  3. Chronic inflammatory infiltration in interstitium and variable degree of fibrosis.

  4. In non-scarred tissue, the glomeruli and vessels may show ischemic change.

D. Others:


E. Reference

  1. Robbins Pathologic Basis of Disease, 6th ed.p.975-977




Fig. 130-1 (2X)The glomerulus reveals collapse or solidification of tuft, and sclerosis change.



Fig. 130-2 (2X)Chronic inflammatory infiltration in interstitium and variable degree of fibrosis with atrophic renal tubules.