KIDNEY - Contracted and Renal Vein Thrombosis

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.