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Image Based Question – 74457

Question

The resected specimen of a kidney is seen below. What is the diagnosis?

A. Acute post-streptococcal glomerulonephritis

B. Flea-bitten kidney of malignant hypertension

C. Chronic glomerulonephritis

D. Amyloidosis

 

Show Answer

Correct Answer » B

Explanation

Ans: B. Flea-bitten kidney of malignant hypertension

(Ref: Robbins 9/e p940)

  • The image is typically showing a flea bitten kidney that is a granular kidney with multiple petechial spots. Flea bitten kidney is a descriptive term referring to the petechial hemorrhages and micro infarctions on the renal cortical surface, typical of malignant hypertension, which are caused by thrombosis in the arcuate and interlobular arteries.
  • The kidney size varies depending on the duration and severity of the hypertensive disease.
  • Small, pinpoint petechial hemorrhages may appear on the cortical surface from rupture of arterioles or glomerular capillaries, giving the kidney a peculiar ‘flea-bitten” appearance.
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