A kidney, somewhat reduced in size, and showing a number of small depressed scars on the surface
leaving a coarsely-granular appearance. The cortex is markedly reduced in thickness, but the
cortico-medullary junction is well defined. There is excess fat in the peripelvic area, and the renal vein
has been opened to show an antemortem thrombus. The thrombus extends into the smaller branches
of the vein, and can be seen at the upper and lower poles of the kidney.
At the age 43, this woman underwent a bypass operation for obesity, and lost some 11 stone
in weight. At the age of 45, she was given phenylbutazone for arthritis of the ankle, but this was
discontinued when a rash appeared. She was later found to be in renal failure, and this was initially
regarded as an arthritis secondary to phenylbutazone, but this was not established. She developed
oxaluria and a renal biopsy showed an interstitial nephritis. This renal damage has been described
after bypass operations, presumably the result of a generalised metabolic upset. The renal vein
thrombosis is presumably a terminal and incidental event; there were areas of infarction described in
the lung; she also had a follicular carcinoma of the thyroid, with metastases in the lung.