CARILLA, BIANCA ADRIANNE C.
| MLS 2-1
Diseases of the Urinary System
Structure × Lining Epithelium
Glomerulonephritis is a group of diseases that cause
inflammation and damage to the glomeruli in the kidneys.
The structure of the glomeruli can become damaged due to
inflammation, causing it to become thickened and scarred.
Polycystic Kidney Disease (PKD) is a genetic disorder that
causes the growth of cysts in the kidneys. The cysts in PKD
are typically filled with fluid and can vary in size. The cysts
can grow within the renal tubules, causing it to become
compressed and leading to a decrease in kidney function.
Obstructive Uropathy is a condition that refers to the
blockage of the urinary tract that impairs urine flow from the
kidneys, ureters, bladder, or urethra. The structural changes
that occur depend on the location and severity of the
blockage, as well as the duration of the condition.
Interstitial cystitis (IC), also known as painful bladder
syndrome (PBS), is a chronic condition that affects the
urinary bladder. The structure of the urinary bladder in IC is
characterized by inflammation and thickening of the
bladder wall, leading to a decrease in bladder capacity.
Urethral caruncle refers to a benign, fleshy outgrowth at the
urethral meatus, which is the external opening of the urethra
in females. The structure of urethral caruncle includes
fibrous connective tissue, blood vessels, and epithelial cells.
× Pathology
The epithelial cells lining the glomeruli can be damaged by
the inflammation that occurs in glomerulonephritis. This
damage can cause thickening and scarring of the
glomerular basement membrane and decrease the filtering
capacity of the glomeruli.
In PKD, the cysts form from the epithelial cells that line the
renal tubules of the kidneys. The cysts can distort and
compress the surrounding tissue, leading to reduced
kidney function over time. Also, cysts may cause chronic
inflammation or fibrosis, further damaging the kidney tissue.
Ureteral obstruction can cause damage to the epithelial
lining, leading to a cellular process called transitional
metaplasia, where normal epithelial cells are replaced by a
different cell that is better suited for the acidic and
hypertonic environment of the obstructed urinary tract.
The lining epithelium of the urinary bladder in IC patients
may show changes such as denudation of the urothelium,
increased infiltration of inflammatory cells, and increased
expression of certain receptors and signaling molecules
involved in inflammation and pain pathways.
The lining epithelium of the urethral caruncle may show
hyperplasia, increased vascularity, and inflammation. The
transitional epithelium may have areas of squamous
metaplasia, and chronic inflammation can be seen in the
underlying stroma.
×
The pathology of glomerulonephritis involves
damage to the glomeruli in the kidneys,
decreasing its ability to filter the blood. This
can be caused by infections, autoimmune
disorders, and genetic conditions.
The pathology of PKD involves the formation
of cysts within the kidney, decreasing kidney
function. PKD is an inherited condition that is
caused by mutations, leading to abnormal
growth and cell proliferation in the kidneys.
The obstruction can be caused by various
factors, including kidney stones, tumors, and
congenital abnormalities. However, it is
commonly associated with Hydronephrosis,
swelling of the kidney due to urine build-up.
Chronic inflammation in IC can lead to
structural changes in the bladder wall,
including the development of scars, ulcers,
and fibrosis. In severe cases, the bladder
becomes small with reduced capacity.
The exact pathogenesis of urethral caruncles
is not well understood, but they are thought
to be related to hormonal changes and
trauma to the area. Symptoms may include
dysuria, urinary frequency, and hematuria.
 CARILLA, BIANCA ADRIANNE C. | MLS 2-1

References ×

Bostwick, D. G., Cheng, L., & Bostwick, D. G. (2018). Urologic surgical pathology.
Elsevier.

Chang, A., & Fogo, A. B. (2019). Glomerular Disease: Glomerulonephritis. In

Comprehensive Clinical Nephrology (6th ed., pp. 173–192). Elsevier.

Klahr, S., & Breyer, J. A. (2018). Obstructive uropathy. In Brenner & Rector's the
kidney (pp. 1135-1151). Elsevier.

Parsons, C. L., & Mulholland, S. G. (2018). Interstitial cystitis: Epidemiology,

clinical presentation, and diagnosis. UpToDate.
https://www.uptodate.com/contents/interstitial-cystitis-epidemiology-
clinical-presentation-and-diagnosis

Torres, V. E., & Harris, P. C. (2019). Autosomal Dominant Polycystic Kidney

Disease. In Comprehensive Clinical Nephrology (6th ed., pp. 231–244). Elsevier.