Definition/General

Introduction:
-Inflammatory changes in the kidney encompass various acute and chronic inflammatory conditions
-These may present as mass-like lesions on imaging mimicking neoplasms
-FNAC helps distinguish inflammatory from neoplastic processes
-Common conditions include pyelonephritis, tuberculosis, and autoimmune diseases.
Origin:
-Result from infectious agents (bacteria, tuberculosis, fungi)
-Autoimmune processes (lupus nephritis, vasculitis)
-Ischemic injury and infarction
-Drug-induced nephritis
-Chronic obstruction leading to inflammation
-May form inflammatory pseudotumors.
Classification:
-Acute pyelonephritis (bacterial infection)
-Chronic pyelonephritis (scarring and atrophy)
-Granulomatous inflammation (tuberculosis, sarcoidosis)
-Autoimmune nephritis (lupus, vasculitis)
-Xanthogranulomatous pyelonephritis
-Inflammatory pseudotumor.
Epidemiology:
-More common in females (urinary tract infections)
-Immunocompromised patients at higher risk
-Diabetes mellitus increases infection risk
-Urinary obstruction predisposes to infection
-Indian population shows high tuberculosis prevalence affecting kidneys.

Clinical Features

Presentation:
-Fever and chills (acute infections)
-Flank pain and tenderness
-Dysuria and frequency
-Renal mass on imaging (inflammatory pseudotumor)
-Constitutional symptoms (weight loss, malaise)
-Hypertension (chronic cases).
Symptoms:
-Acute pyelonephritis: Fever, rigors, flank pain, dysuria
-Chronic pyelonephritis: Recurrent UTIs, flank pain
-Tuberculosis: Constitutional symptoms, sterile pyuria
-Autoimmune: Systemic symptoms, proteinuria
-Mass-like lesions: May be asymptomatic.

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Gross Description

Microscopic Description

Immunohistochemistry

Molecular/Genetic

Differential Diagnosis

Sample Pathology Report

Template Format

Sample Pathology Report

Complete Report: This is an example of how the final pathology report should be structured for this condition.

Clinical Correlation

Patient with [clinical presentation/symptoms/laboratory findings] and [imaging findings]

Specimen Information

FNAC from [renal lesion/kidney mass], performed under [guidance method]

Specimen Adequacy

[Adequate/Inadequate] for cytological interpretation

Cytological Findings

Smears showing [acute/chronic/granulomatous] inflammatory infiltrate. [Cell types] predominate. [Background features]

Inflammatory Pattern

[Acute neutrophilic/Chronic lymphoplasmacytic/Granulomatous/Mixed] inflammatory pattern

Organisms

[No organisms identified/Organisms present/Special stains recommended]

Cytological Diagnosis

[Acute/Chronic/Granulomatous] inflammation - [Specific type if identifiable]

Differential Diagnosis

Inflammatory process. [Specific infectious agents/Autoimmune process] to be considered

Recommendations

[Microbiological studies/Special stains/Serological tests/Clinical correlation] recommended

Note

No evidence of malignancy in the material examined. Clinical correlation and appropriate treatment recommended