THE URINARY ORGANS. 



633 



dense fibrous nodules (Fig. 391). The growth of interstitial tissue in 

 patches may, when near the surface of the organ, bind the capsule to the 

 kidney so that in its removal small masses of the parenchyma may be 

 stripped off, leaving a rough surface on which grayish depressed areas, 

 corresponding to the interstitial growth, are intermingled with more pro- 

 jecting light or yellowish portions, in which albuminous or fatty degen- 

 eration of the tubular epithelium may be marked and extensive. Very 

 often the new fibrous tissue develops along the course of the interlobular 

 vessels so that cylindrical or narrow, wedge-shaped areas are affected, ex- 

 tending inward from the capsule (Fig. 394). Amyloid degeneration in- 

 volving the capillary tufts, the vasa recta, and the larger arterial trunk 

 is common. 



Such kidneys as have just been described present varying gross ap- 

 pearances which are dependent upon the character, extent, and distribu- 



FIG. 393. CHRONIC DIFFUSE N T EPHRITIS. 



Showing swelling of tuft and capsule epithelium ; flattening of the tubular epithelium and slight increase 

 in the interstitial tissue. 



tlou of the lesions. Some are larger than normal Avith a thickened whit- 

 ish or yellowish cortex. These are often called large white kidneys. But 

 kidneys with essentially similar lesions are not always large, are often 

 nearly normal in appearance, or may be smaller and with a cortex thinner 

 than normal. If haemorrhage into the tubules or interstitial tissue be a 



