Nephrectomies for Non-neoplastic Disease
of the nephrectomy specimen is essen-tially the same for neoplastic and
non-neoplastic diseases. Before beginning the dissection, try to establish from
the patient’s clinical history whether fresh cortical tissue should be taken
for immunofluorescence studies or electron micros-copy. Evaluate the kidney,
the hilum, and the perinephric fat as three separate compartments, using the
guidelines of dissection given earlier. When the specimen shows some
modification (e.g., the absence of a perinephric soft tissue compartment),
simply alter the dissection ac-cordingly. Some pathologists may prefer to
evaluate the texture of the cortical surface by stripping the capsule from the
fresh specimen, and this can be done before the kidney is sec-tioned and fixed.
calculi are identified during the dissection, submit some for chemical analysis
if indicated. Because the macroscopic findings often provide crucial clues to
the pathologic process involv-ing the kidney, describe each component of the
kidney individually and systematically (see Table 33-1).