PMC9707366_01
Contrast CT abdomen showing bilateral small pseudoaneurysms in the segmental branches of the renal arteries (A, B) with bilateral renal infarcts (C) with patent bilateral renal vein (D).
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Figure1
CT (CECT) angiography showed bilateral renal infarcts with multiple small pseudoaneurysms in bilateral segmental and subsegmental renal arterial branches with distal occlusion and no evidence of renal vein thrombosis (Figure 1). CT chest and pulmonary angiography showed diffuse ground-glass opacities with fibrotic strands and tractional bronchiectasis suggestive of sequelae to COVID-19 pneumonia.
Cut section of the nephrectomy specimen showing loss of corticomedullary differentiation, replacement of normal parenchyma by necrosed tissue (arrow).
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Figure2
Gross examination of the nephrectomy cut specimen showed loss of corticomedullary distinction and renal was replaced by necrosis and yellowish-black areas involving parts of the kidneys (Figure 2).
A: H & E stain, x 100, microphotograph showing patchy areas of extensive cortical necrosis with intratubular neutrophilic aggregates. B: H & E stain, x 100, microphotograph showing focal area of intratubular neutrophilic aggregates (black arrow) with tubular rupture suggestive of acute pyelonephritis. C: H & E stain, x 100 microphotograph showing suppuration with surrounding epithelioid histiocytic aggregates (black arrow) and multinucleated giant cells (red arrow). D: H & E stain, x 100, microphotograph showing focus of angio-invasive broad aseptate fragmented, irregular branching fungal hyphal elements (black arrow) with morphology consistent with Mucor species.
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Figure3
Histology of the nephrectomy specimen showed cortical infarction and fungal hyphae consistent with mucormycosis (Figure 3).