Cortical necrosis and renal infarct

Know the causes, morphology, and prognosis of cortical necrosis

• Causes

• Abruptio placentae

• Septic shock

• Serious surgical / medical conditions

• Pathology

• Gross – infracted areas interspersed w/ normal or congested areas

• Micro – Ischemic necrosis

• Patchy lesions w/ better preserved areas in cortex

• Massive leukocytic infiltration in areas in contact w/ medulla

• Intravascular and intraglomerular thrombosis  arteriolar necrosis

• Prognosis

• Fatal in diffuse disease

• Compatible w/ survival in focal / unilateral disease

Know the causes and characteristic V-shaped lesion of renal infarct

• Cause

• Embolism (most common cause) – from mural thrombi of left atrium and left ventricle

• Thrombosis b/c of atherosclerosis or vasculitis such as polyarteritis nodosa

• Vegetation of endocarditis

• V-shaped lesion w/ base at cortex and apex pointing towards medulla

• Early stage – congestive discoloration

• W/in 24 hours – yellow-white color

• Late stage (~2 wks) – pale, gray white scar

Category: Pathology Notes