CRP-32
CRP-32
Clinical History
The patient is a 25 year old black female. Status post cadaveric renal transplant three weeks ago Acute rejection by scan. Open biopsy showed apparently viable kidney. Patient has been treated with ATGAM. BUN 80, creatinine 8.5.
Gross Description
Received in transport media is one wedge-shaped fragment of tissue measuring 5 x 3 x 2 mm in greatest dimensions. It is entirely submitted for light microscopy.
Pathology
Case CRP-032 H&E
Case CRP-032 PASH
Case CRP-032 PASH recut
Microscopic Description
Light Microscopy
The specimen consists of a fragment of superficial renal cortex with 44 glomeruli in the three levels. These show minimal mesangial expansion, but they are otherwise unremarkable. There is diffuse marked interstitial edema, and there is focal mild tubular atrophy. There is mild focal interstitial fibrosis immediately beneath the renal capsule. There is a diffuse heavy mononuclear cell infiltrate throughout the biopsy, and numerous examples of tubulitis are identified. The most severely involved tubules contain 8 to 9 lymphocytes per cross section. There is no significant tubular dilatation or epithelial simplification to suggest acute tubular necrosis. Relatively few arterioles and small arteries are identified in the biopsy. There is focal endothelial cell swelling, but the vessels are otherwise unremarkable.