Immunofluorescent staining pattern in a patient with C3 glomerulopathy. There is strong C3 staining in the capillary loops and mesangium. Immunoglobulin staining, such as IgG, is typically absent or at a lower intensity by at least two orders of magnitude than C3. Images courtesy of Patrick Walker, MD.
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Dense deposit disease on electron microscopy in a patient with C3 glomerulopathy. This lesion results from intramembranous transformation of the glomerular basement membrane by sausage-like, “osmiophilic” dense material. Images courtesy of Patrick Walker, MD.
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Membranoproliferative pattern of glomerular injury in a patient with C3 glomerulopathy. This pattern of injury typically has endocapillary proliferation, diffuse capillary wall thickening, increased mesangial matrix, and mesangial proliferation visible on light microscopy, producing a lobular appearance of the glomerular tuft. Images courtesy of Patrick Walker, MD.
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Clusters of interstitial foam cells (arrows) in a kidney biopsy. These are commonly found in biopsy specimens of patients with Alport syndrome, FSGS, IgA nephropathy, and other proteinuric kidney diseases. Image courtesy of Patrick Walker, MD.
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Acute interstitial nephritis with associated acute tubular injury. There is interstitial edema and the tubules are not back to back as would be expected, due to the inflammatory and lymphocytic infiltrate in the interstitial compartment. Note the interstitial eosinophils present in the second image (black arrows). Images courtesy of Joseph…
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Focal segmental glomerulosclerosis (FSGS) in a child presenting with nephrotic syndrome. Image courtesy of Joseph Gaut, MD PhD.
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Numerous PAS-positive protein reabsorption droplets in the renal tubules of a child with minimal change disease. Image courtesy of Joseph Gaut, MD PhD.
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Acute tubular necrosis (ATN). Note the tubules are not back-to-back due to interstitial edema (Masson trichrome staining, not shown, did not show appreciable fibrosis). There is blebbing and sloughing of tubular epithelial cells (black arrows) with loss of the brush border, as well as flattening of the renal tubular epithelium…
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IgA nephropathy with crescents. Note the fibrocellular crescent present in this glomerulus extending from the 3 o’clock the 12 o’clock position. Though difficult to appreciate in this image, there is mild mesangial hypercellularity. Image courtesy of Joseph Gaut, MD PhD.
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PAS stain of a glomerulus in a patient with SLE nephritis. There is endocapillary and mesangial proliferation, as evidenced by thickened, occlusive capillary loops and increased mesangial cellularity. Note the “wire loop” lesions (arrows) and hyaline thrombi present (arrowheads). Image courtesy of Joseph Gaut, MD, PhD.
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