36 year old woman presented with chronic urogenital problems, with persistent low grade fever. She was admitted for renal failure.
The longitudinally bisected surfaces of both kidneys show dilated pelvicalyceal systems with roughened mucosal surfaces from caseous necrosis. There are prominent friable (crumbling) areas of caseous necrosis in the renal cortex and medulla.
Both ureters have thickened fibrotic walls and appear rigid and shortened with narrowed lumina.
The small piece of urinary bladder shows fibrous thickening of the wall with a roughened mucosal surface.