The kidney and ureter are opened to display multiple cavities, based on the calyceal system, lined by
ragged material. At the edge of an occasional cavity, particularly the smaller ones, a collection of
caseous material can be seen. The ureter is slightly thickened, as perhaps can be seen at the
pelvo-ureteric junction. On the reverse of the specimen a number of small caseous nodules can be
This man was admitted to hospital in June 1977 with abdominal pain of 2 days' duration.
Investigation showed a persistent sterile pyuria and a non-functioning left kidney. Direct examination
of bladder washings showed acid-fast bacilli. This man's mother suffered from tuberculosis, and ten
years before he had had an effusion in his right knee which was unexplained. He also showed some
suspicious lesions of his lumbar spine.