Concurrent malignant and benign nephrosclerosis in an elderly cadaver with previously diagnosed cerebral atherosclerosis

We report histopathological features of concurrent malignant and benign nephrosclerosis in an 83-year-old elderly cadaver. Upon routine dissection in a medical school cadaveric anatomy lab, the abdomen of an 83-year-old female showed contracted and granular bilateral kidneys, with subsequent measurements identifying decreased size. Tissue samples were retrieved from the left anterior descending artery, left ventricle wall, bilateral kidneys and lungs. Histopathology slides were prepared using hematoxylin and eosin (H&E) stains. The samples were retrieved from a female cadaver in the Philadelphia College of Osteopathic Medicine, Georgia Body Donor Program. Histopathological findings in the kidneys included fibrinoid necrosis of arterioles, diffuse glomerular shrinkage, hyperplastic arteriosclerosis with onion-skinning appearance, and bilateral diffuse hemorrhages throughout the surface were diagnostic of malignant hypertension. The contracted granular appearance of the kidney and the hyaline arteriosclerosis were diagnostic of a concurrent benign nephrosclerosis. This is in conjunction with findings of left ventricular hypertrophy in the heart and severe atherosclerosis in the left anterior descending artery. Although the incidence of benign nephrosclerosis increases with age, malignant hypertension is rarely seen beyond the fifth decade and affects males rather than females. Our patient was an elderly female in the ninth decade. Malignant hypertension is an important cause of morbidity and mortality and is important to recognize clinically and characterize histopathologically. While the potential additional diagnosis of malignant nephrosclerosis is not reported as one of the final causes of death, the histopathological findings are consistent with known systemic atherosclerosis effects with this cadaver’s previously diagnosed cerebral atherosclerosis.