(2/2) Other findings included glomerulomegaly and focal and segmental glomerulosclerosis. This combination of findings is consistent with sickle cell nephropathy.

(1/2) The biopsy shows tubular hemosiderosis and a sickled cell within a glomerular capillary, which also has segmental basement membrane reduplication and cellular interpositioning.

#renalpath #kidneypath #pathology #renal #pathsky

(2/2) Other findings included glomerulomegaly and focal and segmental glomerulosclerosis. This combination of findings is consistent with sickle cell nephropathy.

(1/2) The biopsy shows tubular hemosiderosis and a sickled cell within a glomerular capillary, which also has segmental basement membrane reduplication and cellular interpositioning.

(2/2) Although no immune deposits are present, the tissue clefts represent the outlines of cholesterol crystals which have lodged within the vascular lumen. This finding is diagnostic of cholesterol microemboli, and it explains the patient’s acute renal failure.

(2/2) ...,chronic renal ischemia, hypertrophy of the arterial and arteriolar walls, chronic volume depletion, Addison disease, renal artery stenosis, cardiac failure, and medications including calcineurin inhibitors, ACEIs or ARBs, and diuretics.

(2/2) The new Banff 2017 Meeting report (see reference below) also places enhanced emphasis on the role of C4d staining (Fig. 2) in peritubular capillaries in the diagnosis of active ABMR – even in the absence of donor specific antibodies.

3/ Although the deposits are monotypic (usually IgG1 kappa), the majority of patients do not have a detectable monoclonal paraprotein, and so far no cases associated with hematologic malignancy have been described.

2/ This entity typically presents in young females, many of which have positive autoimmune serologies but no well-defined autoimmune disease.

1/ The stain depicted is Serum Amyloid Protein (SAP) immunofluorescence. SAP has been recently described as a marker that colocalizes with IgG in cases of membranous-like glomerulopathy with masked IgG kappa deposits.

#renalpath #kidneypath #pathology #renal

3/ Most tophi are also associated with crystalline clefts formed by the deposition of monosodium urate (see arrow). Urate crystals are best seen in alcohol-fixed tissue or in frozen tissue sections, since most crystals dissolve after routine formalin fixation.

2/ Tophi frequently occur in the medulla, and usually consist of central regions of acellular, granular material surrounded by epithelioid macrophages, syncytial-type giant cells, and lymphocytes.