CRP-33

CRP-33

Clinical History

Status post cadaveric transplant 15 months ago. Creatinine 3.0.

Gross Description

Received in transport media is one core measuring 10 mm in length and 0.5 mm in diameter. It is entirely submitted for light microscopy.

Pathology

Case CRP-033 PASH

Microscopic Description, Immunofluorescence, and Electron Microscopy

Microscopic Description

Light Microscopy

The specimen consists of a fragment of renal cortex with a small portion of capsule on one end. There are sixteen glomeruli in the three levels examined. Three of these area obsolete, but the remainder are similar and show essentially normal morphology. There is mild patchy interstitial fibrosis with corresponding focal mild tubular atrophy. Occasional small collections of lymphocytes are present in the more fibrotic areas, and examples of mild tubulitis are identified in all three levels. However, the degree of tubulitis is relatively mild, with only two or three lymphocytes generally identified per tubular cross-section. The arterioles and small arteries show minimal intimal thickening, but they are otherwise unremarkable.

Diagnosis and Comments

Kidney, transplant, needle biopsy·- Very mild acute interstitial rejection (Banff borderline).

These findings are most consistent with mild acute interstitial rejection. Overall, the tubulointerstitial preservation is quite good, and there are no significant pathologic changes in the glomeruli or vessels.