All are true of Benign nephrosclerosis except
Correct Answer: Hyperplastic arteriolitis
Description: Benign nephrosclerosis is the term used for the renal pathology associated with sclerosis of renal arterioles and small arteries. The resultant effect is focal ischemia of parenchyma supplied by vessels with thickened walls and consequent narrowed lumens. The parenchymal effects include glomerulosclerosis and chronic tubulointersititial injury, producing a reduction in functional renal mass. The kidneys are either normal or moderately reduced in size. The cortical surfaces have a fine, even granularity that resembles grain leather. The loss of mass is due mainly to cortical scarring and shrinking. On histologic examination there is narrowing of the lumens of arterioles and small arteries, caused by thickening and hyalinization of the walls (hyaline arteriolosclerosis). Corresponding to the fine surface granulations are microscopic subcapsular scars with sclerotic glomeruli and tubular dropout, alternating with better preserved parenchyma. In addition, the interlobular and arcuate arteries show a characteristic lesion that consists of medial hypertrophy, reduplication of the elastic lamina, and increased myofibroblastic tissue in the intima, which combine to narrow the lumen. This change, called fibroelastic hyperplasia, often accompanies hyaline arteriolosclerosis and increases in severity with age and in the presence of hypertension.
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