CRP-42: Difference between revisions
Created page with "'''CRP-42''' ==Clinical History== ==Gross Description:== ==Pathology== ===Case CRP-042 H&E=== <peir-vm>specialcrp/CRP-042_HE</peir-vm> ===Case CRP-042 PASH=== <peir-vm>specialcrp/CRP-042_PASH</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"> ==M..." |
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'''CRP-42''' | '''CRP-42''' | ||
==Clinical History== | ==Clinical History== | ||
Thirteen-year-old black female with sickle cell disease, systemic lupus erythematosus and proteinuria. Percutaneous needle biopsy of the right kidney was performed. | |||
==Gross Description | ==Gross Description== | ||
The specimen is labeled “Renal bx”. It consists of two portions of light tan tissue measuring 0 8 x 0.1 x 0.1 cm and 0.3 x 0.1 x 0.1 cm. (Jar 0) | |||
==Pathology== | ==Pathology== | ||
| Line 14: | Line 16: | ||
<div class="mw-collapsible-content"> | <div class="mw-collapsible-content"> | ||
==Microscopic Description | ==Microscopic Description== | ||
===Light Microscopy | ===Light Microscopy=== | ||
The sections show portions of sub capsular cortex. Up to twelve glomeruli are available for examination on multiple sections. The glomeruli are enlarged and show mild segmental expansion of the mesangial matrix and segmental thickening of the peripheral capillary walls, which have a beaded appearance on trichrome and Jones silver stains. Numerous capillary loops are ectatic and contain sickled erythrocytes. No globally or segmentally sclerosed glomeruli are found. The interstitium, tubules and blood vessels are essentially unremarkable. One tubulointerstitial calcific deposit is noted. There are no detectable glomerular or tubular hemosiderin deposits. ABPASH, trichrome and Jones silver stains have appropriately reactive controls. | |||
===Immunofluorescence | ===Immunofluorescence=== | ||
One glomerulus is available for examination by immunofluorescence on sections stained with IgG, IgM, IgA, C1q and C3. There is finely granular basement membrane staining with IgM (1+) and linearly granular staining with IgA (trace). No glomerular staining is noted with IgG, C1q and C3. No glomeruli are available for examination on sections stained with C4, fibrinogen, albumin or kappa and lambda light chains. | |||
===Electron Microscopy=== | |||
Three glomeruli are present on multiple plastic-embedded BFMB-stained sections. The glomeruli are enlarged and show segmental mesangial matrix expansion and segmental thickening of the capillary walls. The capillary lumina contain sickled erythrocytes. Ultrastructural examination shows segmental thinning and segmental wrinkling of the glomerular basement membranes. There is extensive mesangial interposition and segmental accumulation of subendothelial flocculent material. The capillary lumina are ectatic and contain sickled erythrocytes. The mesangium is expanded by basement membrane-like material. There is segmental foot process obliteration of the visceral epithelial cells. Some of the visceral epithelial cells contain irregular electron dense iron deposits and ingested effete erythrocytes. No electron-dense deposits are recognized. | |||
</div></div> | </div></div> | ||
<spoiler text="Diagnosis and Comments"> | <spoiler text="Diagnosis and Comments"> | ||
Kidney, right, biopsy: | |||
Sickle Cell Nephropathy | |||
The biopsy shows light microscopy, immunofluorescence and ultrastructural features of the nephropathy of sickle cell disease. Features of systemic lupus erythematosus are not recognized. | |||
</spoiler> | </spoiler> | ||
Revision as of 08:29, 8 October 2026
CRP-42
Clinical History
Thirteen-year-old black female with sickle cell disease, systemic lupus erythematosus and proteinuria. Percutaneous needle biopsy of the right kidney was performed.
Gross Description
The specimen is labeled “Renal bx”. It consists of two portions of light tan tissue measuring 0 8 x 0.1 x 0.1 cm and 0.3 x 0.1 x 0.1 cm. (Jar 0)
Pathology
Case CRP-042 H&E
Case CRP-042 PASH
Microscopic Description
Light Microscopy
The sections show portions of sub capsular cortex. Up to twelve glomeruli are available for examination on multiple sections. The glomeruli are enlarged and show mild segmental expansion of the mesangial matrix and segmental thickening of the peripheral capillary walls, which have a beaded appearance on trichrome and Jones silver stains. Numerous capillary loops are ectatic and contain sickled erythrocytes. No globally or segmentally sclerosed glomeruli are found. The interstitium, tubules and blood vessels are essentially unremarkable. One tubulointerstitial calcific deposit is noted. There are no detectable glomerular or tubular hemosiderin deposits. ABPASH, trichrome and Jones silver stains have appropriately reactive controls.
Immunofluorescence
One glomerulus is available for examination by immunofluorescence on sections stained with IgG, IgM, IgA, C1q and C3. There is finely granular basement membrane staining with IgM (1+) and linearly granular staining with IgA (trace). No glomerular staining is noted with IgG, C1q and C3. No glomeruli are available for examination on sections stained with C4, fibrinogen, albumin or kappa and lambda light chains.
Electron Microscopy
Three glomeruli are present on multiple plastic-embedded BFMB-stained sections. The glomeruli are enlarged and show segmental mesangial matrix expansion and segmental thickening of the capillary walls. The capillary lumina contain sickled erythrocytes. Ultrastructural examination shows segmental thinning and segmental wrinkling of the glomerular basement membranes. There is extensive mesangial interposition and segmental accumulation of subendothelial flocculent material. The capillary lumina are ectatic and contain sickled erythrocytes. The mesangium is expanded by basement membrane-like material. There is segmental foot process obliteration of the visceral epithelial cells. Some of the visceral epithelial cells contain irregular electron dense iron deposits and ingested effete erythrocytes. No electron-dense deposits are recognized.