case_images: PMC4996589_01
case_images: Noncontrast CT scan images. Left panel showing severe hydronephrosis of left kidney with a vascular calcification and an atrophic right kidney. Right panel showing necrotic debris in renal collecting system (arrow).
case_images: fig-1.jpg
case_images: PMC4996589_01_fig-1.jpg
case_images: f1
case_images: A 72-year-old male with a past medical history of hypertension, chronic kidney disease, a solitary functioning left kidney (right kidney atrophic from unknown cause), and protein C deficiency (PCD) with baseline creatinine of 4 mg/dL presented with flank pain, and upon evaluation he was found to have severe left hydroureteronephrosis (Fig. 1) with an elevation of his creatinine to 12.2 mg/dL.
case_images: Hematoxylin and eosin section showing necrotic tissue from renal papilla, granulation tissue with young fibroblasts, and abundant vessels with reactive endothelium, and adjacent fibrin with many neutrophils and nuclear debris.
case_images: fig-2.jpg
case_images: PMC4996589_01_fig-2.jpg
case_images: f2
case_images: Pathologic evaluation was consistent with necrotic renal papillae without any signs of invasion with cancer or infection (Fig. 2).