The pathological change in this image which is marked by A
Cystic medial necrosis
This image is kidney malignant hypertension
- Uncommon occurs in 1-5% of hypertensive patients: can develop in previously healthy patients but is more often superimposed on preexisting benign hypertension or chronic renal disease.
- Usually affects young males and in African Americans.
- Initial insult suggested being vascular damage in kidney, leading to fibrinoid necrosis of small vessels and hyperplastic arteriolosclerosis, renal ischemia, renin-angiotensin system stimulated (markedly elevated renin).
- Etiology is variable, but clinical course is severe and if left untreated has a rapidly downhill progression.
- Full blown syndrome characterized by diastolic hypertension >130 mmHg, papilledema retinopathy, encephalopathy, cardiovascular abnormality, and renal failure.