[Polycystic renal diseases: morphology and genetic counseling]

The designation "polycystic kidneys" is vague and causes considerable confusion. This term comprises a number of affections, characterized by the presence of renal cysts. Cystic kidneys may be hereditary or sporadic. The defect may be isolated or occur as part of a syndrome. The identification of the exact nature of the lesion is therefore of paramount importance, not only for the prognosis of the propositus, but especially for the correct genetic counselling of the family. In this context, the perinatal autopsy represents an irreplaceable method of investigation. Since the pathogenesis of many, if not all, types of polycystic kidneys remains unknown, a practical classification must be based on gross and microscopic pathologic study, clinical features, and family history. Osathanondh and Potter (1964) distinguished four varieties, based on morphological findings, revealed by microdissection. Unfortunately, not all types of cystic kidneys are included in this classification. Moreover, their type III cystic kidney collects a number of clearly different entities. Nevertheless, once one is familiar with its deficiencies, the Osathanondh and Potter classification is still very useful.