CRP-30 - Revision history

Peter Anderson at 14:32, 8 October 2026

2026-10-08T14:32:06Z

← Older revision		Revision as of 09:32, 8 October 2026
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	<div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer"> Microscopic Description, Immunofluorescence, and Electron Microscopy.</div>		<div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer"> Microscopic Description, Immunofluorescence, and Electron Microscopy</div>
	<div class="mw-collapsible mw-collapsed" id="mw-customcollapsible-diagnosis">		<div class="mw-collapsible mw-collapsed" id="mw-customcollapsible-diagnosis">
	<div class="mw-collapsible-content">		<div class="mw-collapsible-content">

Peter Anderson at 13:04, 8 October 2026

2026-10-08T13:04:53Z

← Older revision		Revision as of 08:04, 8 October 2026
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	'''CRP-30'''		'''CRP-30'''
	==Clinical History==		==Clinical History==
			The patient is a 42 year old male who is status post double lung transplant two years ago for alpha-1-antitrypsin deficiency. The patient has nephrotic range proteinuria. BUN 44, creatinine 2.3, creatinine clearance 65 ml/min, urinary protein 6.5 g/24 hr. BP 144/90.

	==Gross Description:==		==Gross Description==
			Received in transport media is one core measuring l.5 cm in length and 2 mm in diameter. Two l mm pieces are taken for EM, a 4 mm piece is taken for immunofluorescence, and the remaining tissue is processed for light microscopy.

	==Pathology==		==Pathology==
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	<div class="mw-collapsible-content">		<div class="mw-collapsible-content">

	==Microscopic Description:==		==Microscopic Description==
	===Light Microscopy:===		===Light Microscopy===
			The specimen consists of a fragment of renal cortex that contains at least 12 glomeruli. Five of these are obsolete. The remaining glomeruli show a range of morphology. Some of them show essentially normal morphology, but most show varying degrees of mesangial sclerosis with a few exhibiting segmental sclerosis and complete collapse of the capillary tufts. A few of the glomeruli also demonstrate prominent congestion. There is no glomerular necrosis, and no thrombi are identified in any of the glomeruli. Mesangial cellularity is only mildly increased. There is diffuse moderate interstitial fibrosis with corresponding tubular atrophy. Many of the remaining tubules demonstrate dilation, epithelial simplification and focal epithelial cell necrosis. Occasional lymphocytes and plasma cells are scattered throughout the interstitium, but there is no tubulitis. The most striking change in the biopsy is in the arterioles and small arteries. The arterioles uniformly show marked hyalinosis with almost complete obliteration of the lumina. The small arteries show moderate intimal mucoid thickening. Several of the arterioles also contain fibrin thrombi. None of the vessels demonstrate vasculitis.

	===Immunofluorescence:===		===Immunofluorescence===
			There are eighteen glomeruli in the sections. Three of these are obsolete. There is trace mesangial staining for IgM diffusely, and there is 2+ focal and segmental mesangial staining for IgM, IgA, C3 and light chains. Blood vessels show 2+ irregular staining for C3.

	~~===Electron Microscopy:===~~

			===Electron Microscopy===
			Two thick sections containing a total of eleven glomeruli are available. One of these is obsolete, but the rest show essentially normal morphology by light microscopy. Ultrastructural examination reveals mild thickening of the glomerular basement membranes, and there is only focal fusion of the visceral cell foot processes. Mesangial regions are slightly expanded by matrix but there is no significant mesangial cell proliferation. No electron dense deposits are identified in the glomeruli. The tubules show atrophy and focal epithelial cell necrosis.

	</div></div>		</div></div>

	<spoiler text="Diagnosis and Comments">		<spoiler text="Diagnosis and Comments">
			Kidney, needle biopsy - Marked hyaline arteriolosclerosis and focal arteriolar thrombosis, consistent with cyclosporine-associated arteriopathy.

			These findings are most consistent with cyclosporine arteriopathy. The vascular lesions are quite characteristic. However, similar histology may also be seen in thrombotic microangiopathy, which should be ruled out clinically. The sever degree of vascular injury portends a very poor prognosis for this kidney.

	</spoiler>		</spoiler>

Peter Anderson: Created page with "'''CRP-30''' ==Clinical History== ==Gross Description:== ==Pathology== ===Case CRP-030 H&E=== specialcrp/CRP-030_HE ===Case CRP-030 PASH=== specialcrp/CRP-030_PASH ===Case CRP-030 Silver=== specialcrp/CRP-030_Silver ===Case CRP-030 Trichrome=== specialcrp/CRP-030_Trichrome
Microscopic Description, Immunofluorescence, an..."

2026-10-07T17:55:55Z

Created page with "'''CRP-30''' ==Clinical History== ==Gross Description:== ==Pathology== ===Case CRP-030 H&E=== <peir-vm>specialcrp/CRP-030_HE</peir-vm> ===Case CRP-030 PASH=== <peir-vm>specialcrp/CRP-030_PASH</peir-vm> ===Case CRP-030 Silver=== <peir-vm>specialcrp/CRP-030_Silver</peir-vm> ===Case CRP-030 Trichrome=== <peir-vm>specialcrp/CRP-030_Trichrome</peir-vm> <div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer"> Microscopic Description, Immunofluorescence, an..."

New page

'''CRP-30'''
==Clinical History==

==Gross Description:==

==Pathology==
===Case CRP-030 H&E===
<peir-vm>specialcrp/CRP-030_HE</peir-vm>
===Case CRP-030 PASH===
<peir-vm>specialcrp/CRP-030_PASH</peir-vm>
===Case CRP-030 Silver===
<peir-vm>specialcrp/CRP-030_Silver</peir-vm>
===Case CRP-030 Trichrome===
<peir-vm>specialcrp/CRP-030_Trichrome</peir-vm>

<div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer"> Microscopic Description, Immunofluorescence, and Electron Microscopy.</div>
<div class="mw-collapsible mw-collapsed" id="mw-customcollapsible-diagnosis">
<div class="mw-collapsible-content">

==Microscopic Description:==
===Light Microscopy:===

===Immunofluorescence:===

===Electron Microscopy:===

</div></div>

<spoiler text="Diagnosis and Comments">

</spoiler>