Renal Pathology - Revision history

Peter Anderson at 21:15, 4 October 2026

2026-10-04T21:15:22Z

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 ===Case RP-001 Silver===
 <peir-vm>specialcrp/CRP-001_Silver</peir-vm>
 <div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer"> Microscopic Description, Immunofluorescence, and Electron Microscopy.</div>

Peter Anderson: /* Case RP-001 */

2026-10-04T18:54:20Z

Case RP-001

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	'''Renal Pathology Cases.''' These renal pathology cases were collected by William Cook, M.D., PhD as a teaching set for use by UAB pathology residents interested in renal pathology. Virtual Microscopy slides were curated and made available on PEIR by Dr. Peter Anderson and Bade Iriabho.		'''Renal Pathology Cases.''' These renal pathology cases were collected by William Cook, M.D., PhD as a teaching set for use by UAB pathology residents interested in renal pathology. Virtual Microscopy slides were curated and made available on PEIR by Dr. Peter Anderson and Bade Iriabho.

	==Case RP-001==		=='''Case RP-001'''==

	== Clinical History==		== Clinical History==

Peter Anderson: /* Case RP-001 */

2026-10-04T18:53:46Z

Case RP-001

← Older revision		Revision as of 13:53, 4 October 2026
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	'''Renal Pathology Cases.''' These renal pathology cases were collected by William Cook, M.D., PhD as a teaching set for use by UAB pathology residents interested in renal pathology. Virtual Microscopy slides were curated and made available on PEIR by Dr. Peter Anderson and Bade Iriabho.		'''Renal Pathology Cases.''' These renal pathology cases were collected by William Cook, M.D., PhD as a teaching set for use by UAB pathology residents interested in renal pathology. Virtual Microscopy slides were curated and made available on PEIR by Dr. Peter Anderson and Bade Iriabho.

	==~~'''~~Case RP-001~~'''~~==		==Case RP-001==

	== Clinical History==		== Clinical History==
	The patient is a 76 year old female.		The patient is a 76 year old female.

Peter Anderson at 18:52, 4 October 2026

2026-10-04T18:52:40Z

← Older revision		Revision as of 13:52, 4 October 2026
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	This pattern of diffuse proliferative glomerulonephritis is not specific and may occur in association with a number of systemic diseases, including autoimmune diseases, infections, and chronic liver disease. The presence of so many neutrophils in conjunction with large subepithelial deposits is most consistent with acute postinfectious glomerulonephritis. Although acute postinfectious glomerulonephritis is most typically associated with streptococcal infections, the MPGN-like features of the lesion (focal mesangial interposition, subendothelial deposits) suggests a chronic infection. The most common chronic infections associated with this type of glomerulonephritis include hepatitis B or C, visceral abscess, and mycoplasma.		This pattern of diffuse proliferative glomerulonephritis is not specific and may occur in association with a number of systemic diseases, including autoimmune diseases, infections, and chronic liver disease. The presence of so many neutrophils in conjunction with large subepithelial deposits is most consistent with acute postinfectious glomerulonephritis. Although acute postinfectious glomerulonephritis is most typically associated with streptococcal infections, the MPGN-like features of the lesion (focal mesangial interposition, subendothelial deposits) suggests a chronic infection. The most common chronic infections associated with this type of glomerulonephritis include hepatitis B or C, visceral abscess, and mycoplasma.
			</div></div>

	<spoiler text="Diagnosis and Comments">		<spoiler text="Diagnosis and Comments">

Peter Anderson at 18:47, 4 October 2026

2026-10-04T18:47:46Z

← Older revision		Revision as of 13:47, 4 October 2026
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	Recently detected renal insufficiency, proteinuria and hypertension. BUN 50, creatinine 2.6, creatinine clearance 36 ml/min, urinary protein 3.5 g/24 hr. BP 150/90.		Recently detected renal insufficiency, proteinuria and hypertension. BUN 50, creatinine 2.6, creatinine clearance 36 ml/min, urinary protein 3.5 g/24 hr. BP 150/90.

	===Gross Description:===		==Gross Description:==
	Received in Zeus fixative is one core of renal tissue measuring 1.1 cm in length. This is entirely submitted for immunofluorescence. Received in Carson's fixative are two cores of tissue measuring 8 mm each. Two 1-mm fragments are taken for EM, and the remaining tissue is processed for light microscopy.		Received in Zeus fixative is one core of renal tissue measuring 1.1 cm in length. This is entirely submitted for immunofluorescence. Received in Carson's fixative are two cores of tissue measuring 8 mm each. Two 1-mm fragments are taken for EM, and the remaining tissue is processed for light microscopy.

	==Pathology==		==Pathology==
	~~<gallery heights~~=~~"250px" widths~~=~~"250px"~~>		===Case RP-001 H&E===
	~~CytologicallyYoursCoW20131125Cytology1.jpg\|4x magnification of the specimen. We see colloid, few small clusters of cells macrophages, and scattered cells in the background.~~		<peir-vm>specialcrp/CRP-001_HE</peir-vm>
	~~CytologicallyYoursCoW20131125Cytology2.jpg\|20x magnification. Colloid is present at the bottom of the field. There are single cells in the background and small groups of cells.~~		===Case RP-001 PASH===
	~~CytologicallyYoursCoW20131125Cytology3.jpg\|40x magnification of a large multinucleated giant cell. There is colloid and macrophages present in the background.~~		<peir-vm>specialcrp/CRP-001_PASH</peir-vm>
	~~CytologicallyYoursCoW20131125Cytology4.jpg\|10x magnification. Here we have a large cohesive group of spindled epithelioid cells. The centers are non~~-~~necrotizing. In the background there is colloid and single cells present.~~		===Case RP-001 Silver===
	~~CytologicallyYoursCoW20131125Cytology5.jpg\|10x magnification. Here there are more groups of cohesive epithleioid spindled cells with non~~-~~necrotizing centers.~~		<peir-vm>specialcrp/CRP-001_Silver</peir-vm>
	~~CytologicallyYoursCoW20131125Cytology6.jpg\|40x magnification of a group of cohesive epithelioid spindled cells with non~~-~~necrotizing center.~~
	</~~gallery~~>

	~~===Resident Questions===~~		<div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer"> Microscopic Description, Immunofluorescence, and Electron Microscopy.</div>
	* <spoiler text="Benign or malignant?">
	~~These groups of cohesive spindled epithelioid cells are also known as granulomas. Granulomatous thyroiditis is a benign entity.~~
	~~</spoiler>~~
	* <spoiler text="With these cytologic findings what should be included in our differential diagnosis?">
	When we see granulomas in a thyroid we should always think of an infectious process, sarcoidosis, Hashimoto's thyroiditis, palpation thyroiditis, and granulomatous thyroiditis. The other entity that you should think of when you see epithelioid giant cells is papillary thyroid carcinoma.
	~~</spoiler>~~

	<div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer"> ~~Click here to toggle the diagnosis~~ and ~~case discussion~~.</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">

	==~~Diagnosis~~==		==Microscopic Description:==
	===~~Cytology~~===		===LIGHT MICROSCOPY:===
	~~'''Benign aspirate~~, ~~see comment'''~~.		The specimen consists of two fragments of renal cortex that contain at least 36 glomeruli. Four of these are obsolete. The remaining glomeruli are all similar and show striking diffuse proliferation with accentuation of the normal lobular pattern. Many of the extra cells in the glomeruli are polymorphonuclear leukocytes. Because of the marked mesangial and endocapillary proliferation, Very few capillary loops are still patent. Silver and PASH stains show thickening of the capillary basement membranes, and examples of double contours consistent with mesangial interposition are identified with the silver stain. The trichrome stain shows reddish-orange subendothelial deposits in some of the loops, which probably represent immune complex deposits. No segmental sclerosis or necrosis is identified, and there are no epithelial crescents. There is diffuse mild interstitial fibrosis, and there is focal mild tubular atrophy. However, many of the tubules still show very good preservation. Occasional lymphocytes and plasma cells are scattered throughout the interstitium, but no large collections of inflammatory cells are present. There is no tubulitis. The small arteries in the biopsy show minimal intimal fibrosis, and there is no evidence of vasculitis.

	~~'''COMMENT'''~~:		===Immunofluorescence:===
	~~'''~~There are ~~non-necrotizing granulomas~~, ~~benign follicular cells~~, ~~macrophages~~, ~~colloid, lymphocytes~~, and ~~multinucleated giant cells; consistent with granulomatous thyroiditis'''~~.		There are sixteen glomeruli in the sections. None contain epithelial crescents or foci of segmental sclerosis. There is diffuse, coarse, granular staining along the capillary loops that is graded 4+ for C3, 2+ for IgG and light chains, and l+ for IgA. There is also focal and segmental l+ staining of the capillary loops for Clq. There is staining of similar intensity in the mesangial regions for all of these reagents. There is no staining in the glomeruli for IgM. Tubular epithelium contains occasional albumin droplets. There is no staining of the tubular basement membranes. There is no staining of the vessels

	==~~Case Discussion~~==		===Electron Microscopy:===
	~~Granulomatous Thyroiditis~~ is ~~also known as deQuervain or subacute thyroiditis~~. It is ~~a postviral syndrome~~. ~~Usual presentation is in a young woman who has just gotten over a cold~~.		Two thick sections are available. One contains two glomeruli, but the other contains only a portion of a glomerulus on one edge. These are similar to those described under light microscopy and show striking diffuse hypercellularity with compromise of the capillary lumina. Many of the capillary lumina are completely ·filled with polymorphonuclear leukocytes. Capillary basement membranes are generally of normal thickness, but there is focal thickening with mesangial cell interposition. There is diffuse effacement of the visceral epithelial foot processes. Numerous subendothelial electron dense deposits are identified, and occasional small mesangial electron dense deposits are also noted. Subepithelial deposits are easily identified, and some are extremely large ("humps").

	~~Patients present~~ with ~~painful thyroid~~, ~~fever~~, ~~fatigue~~, ~~chills~~. ~~Diagnosis~~ is ~~usually made clinically~~, ~~therefore FNA biopsy is usually not performed~~. The ~~disease is usually self-limiting~~.		This pattern of diffuse proliferative glomerulonephritis is not specific and may occur in association with a number of systemic diseases, including autoimmune diseases, infections, and chronic liver disease. The presence of so many neutrophils in conjunction with large subepithelial deposits is most consistent with acute postinfectious glomerulonephritis. Although acute postinfectious glomerulonephritis is most typically associated with streptococcal infections, the MPGN-like features of the lesion (focal mesangial interposition, subendothelial deposits) suggests a chronic infection. The most common chronic infections associated with this type of glomerulonephritis include hepatitis B or C, visceral abscess, and mycoplasma.

	~~If an aspirate is performed it may be scantly cellular due to pain~~ and ~~fibrosis. If material is gathered you may see non-caseating granulomas~~, ~~colloid~~, ~~chronic inflammation, and multinucleated giant cells~~.		<spoiler text="Diagnosis and Comments">
			Kidney, needle biopsy · Diffuse proliferative glomerulonephritis, consistent with acute postinfectious glomerulonephritis (see description).

	</~~div></div~~>		T71000 KIDNEY, P11430 BIOPSY, NEEDLE, M46812 GLOMERULONEPHRJTIS, PROLIFERATIVE, DIFFUSE
			M40000 GLOMERULONEPHRITIS, T71200 GLOMERULUS
	~~{{Cytologically Yours}}~~		</spoiler>
	~~[[Category: Case Reports]]~~

Peter Anderson at 21:13, 3 October 2026

2026-10-03T21:13:10Z

← Older revision		Revision as of 16:13, 3 October 2026
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	== Renal Pathology Virtual Microscopy Study Set ==		== Renal Pathology Virtual Microscopy Study Set ==
	'''Renal Pathology Cases.''' These renal pathology cases were collected by William Cook, M.D., PhD as a teaching set for use by UAB pathology residents interested in renal pathology. Virtual Microscopy slides were curated and made available on PEIR by Dr. Peter Anderson and Bade Iriabho.		'''Renal Pathology Cases.''' These renal pathology cases were collected by William Cook, M.D., PhD as a teaching set for use by UAB pathology residents interested in renal pathology. Virtual Microscopy slides were curated and made available on PEIR by Dr. Peter Anderson and Bade Iriabho.

			=='''Case RP-001'''==
			== Clinical History==
			The patient is a 76 year old female.

			Recently detected renal insufficiency, proteinuria and hypertension. BUN 50, creatinine 2.6, creatinine clearance 36 ml/min, urinary protein 3.5 g/24 hr. BP 150/90.

			===Gross Description:===
			Received in Zeus fixative is one core of renal tissue measuring 1.1 cm in length. This is entirely submitted for immunofluorescence. Received in Carson's fixative are two cores of tissue measuring 8 mm each. Two 1-mm fragments are taken for EM, and the remaining tissue is processed for light microscopy.

			==Pathology==
			<gallery heights="250px" widths="250px">
			CytologicallyYoursCoW20131125Cytology1.jpg\|4x magnification of the specimen. We see colloid, few small clusters of cells macrophages, and scattered cells in the background.
			CytologicallyYoursCoW20131125Cytology2.jpg\|20x magnification. Colloid is present at the bottom of the field. There are single cells in the background and small groups of cells.
			CytologicallyYoursCoW20131125Cytology3.jpg\|40x magnification of a large multinucleated giant cell. There is colloid and macrophages present in the background.
			CytologicallyYoursCoW20131125Cytology4.jpg\|10x magnification. Here we have a large cohesive group of spindled epithelioid cells. The centers are non-necrotizing. In the background there is colloid and single cells present.
			CytologicallyYoursCoW20131125Cytology5.jpg\|10x magnification. Here there are more groups of cohesive epithleioid spindled cells with non-necrotizing centers.
			CytologicallyYoursCoW20131125Cytology6.jpg\|40x magnification of a group of cohesive epithelioid spindled cells with non-necrotizing center.
			</gallery>

			===Resident Questions===
			* <spoiler text="Benign or malignant?">
			These groups of cohesive spindled epithelioid cells are also known as granulomas. Granulomatous thyroiditis is a benign entity.
			</spoiler>
			* <spoiler text="With these cytologic findings what should be included in our differential diagnosis?">
			When we see granulomas in a thyroid we should always think of an infectious process, sarcoidosis, Hashimoto's thyroiditis, palpation thyroiditis, and granulomatous thyroiditis. The other entity that you should think of when you see epithelioid giant cells is papillary thyroid carcinoma.
			</spoiler>

			<div class="usermessage mw-customtoggle-diagnosis" style="cursor:pointer"> Click here to toggle the diagnosis and case discussion.</div>
			<div class="mw-collapsible mw-collapsed" id="mw-customcollapsible-diagnosis">
			<div class="mw-collapsible-content">

			==Diagnosis==
			===Cytology===
			'''Benign aspirate, see comment'''.

			'''COMMENT''':
			'''There are non-necrotizing granulomas, benign follicular cells, macrophages, colloid, lymphocytes, and multinucleated giant cells; consistent with granulomatous thyroiditis'''.

			==Case Discussion==
			Granulomatous Thyroiditis is also known as deQuervain or subacute thyroiditis. It is a postviral syndrome. Usual presentation is in a young woman who has just gotten over a cold.

			Patients present with painful thyroid, fever, fatigue, chills. Diagnosis is usually made clinically, therefore FNA biopsy is usually not performed. The disease is usually self-limiting.

			If an aspirate is performed it may be scantly cellular due to pain and fibrosis. If material is gathered you may see non-caseating granulomas, colloid, chronic inflammation, and multinucleated giant cells.

			</div></div>

			{{Cytologically Yours}}
			[[Category: Case Reports]]

Peter Anderson at 21:06, 3 October 2026

2026-10-03T21:06:35Z

← Older revision		Revision as of 16:06, 3 October 2026
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	== Renal Pathology Virtual Microscopy Study Set ==		== Renal Pathology Virtual Microscopy Study Set ==
	Renal Pathology Cases. These renal pathology cases were collected by William Cook, M.D. as a teaching set for use by UAB pathology residents interested in renal pathology. Virtual Microscopy slides were curated and made available on PEIR by Dr. Peter Anderson and Bade Iriabho.		'''Renal Pathology Cases.''' These renal pathology cases were collected by William Cook, M.D., PhD as a teaching set for use by UAB pathology residents interested in renal pathology. Virtual Microscopy slides were curated and made available on PEIR by Dr. Peter Anderson and Bade Iriabho.

Peter Anderson at 21:02, 3 October 2026

2026-10-03T21:02:52Z

← Older revision		Revision as of 16:02, 3 October 2026
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	Renal Pathology		== Renal Pathology Virtual Microscopy Study Set ==
			Renal Pathology Cases. These renal pathology cases were collected by William Cook, M.D. as a teaching set for use by UAB pathology residents interested in renal pathology. Virtual Microscopy slides were curated and made available on PEIR by Dr. Peter Anderson and Bade Iriabho.

Bade: Replaced content with "Renal Pathology"

2026-10-01T16:15:08Z

Replaced content with "Renal Pathology"

← Older revision		Revision as of 11:15, 1 October 2026
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	Renal Pathology		Renal Pathology

	~~=== Images ===~~
	~~<gallery heights="250px" widths="250px">~~
	File:library/upload/2013/08/01/20130801120507-609e1720.jpg\|This is a gross photograph of the heart from this case demonstrating the well-formed thrombus (arrow) tightly attached to the myocardium near the apex of the left ventricle.
	~~</gallery>~~

Bade at 16:05, 1 October 2026

2026-10-01T16:05:31Z

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	=== Images ===		=== Images ===
	* [{{SERVER}}/~~library~~/~~picture.php?~~/~~17047~~/~~category~~/~~108&metadata: ADRENAL Case# 33236]~~		<gallery heights="250px" widths="250px">
			File:library/upload/2013/08/01/20130801120507-609e1720.jpg\|This is a gross photograph of the heart from this case demonstrating the well-formed thrombus (arrow) tightly attached to the myocardium near the apex of the left ventricle.
			</gallery>