Diabetic Nephopathy - path pt.

Question 1

What is the most important stage of Diabetic Nephropathy to be able to identify on Histology?

• how is it identified?

Answer 1

Most Important Stage - STAGE III:
• NODULAR glomerulosclerosis => KIMMELSTEIL-WILSON NODULES

***Note: in stage IV the glomeruli become so sclerotic that you can barely make out the basement membrane***

Question 2

What disease resembles Diabetic Nephropathy on histology?

• how do you differentiate these diseases?

Answer 2

Diabetic Nephropathy and Light Chain Disease resemble each other on Histology with Nodular Glomerulosclerosis

• IMMUNOFLUROSCENCE helps to differentiate between these two things

Question 3

What is shown here?
• what is the green arrow pointing to?
• what is the orange arrow pointing to?
• DDx.

Answer 3

Green Arrow:
• Kimmilstiel-Wilson Nodule

Orange Arrow:
• Hyaline Arteriolosclerosis - VERY common in diabetics

To Differentiate Diabetic Nodular Glomerulosclerosis and Light Chain Disease you must do Immunofluorscence

Question 4

What tubular findings would you expect to see in Diabetic Nephropathy?

Answer 4

DIALATED tubules with HYALINE deposits inside

Question 5

What happened to this kidney?

Answer 5

Transplant Rejection

Question 6

Whis is shown here?
• what if it immunofluorusces? What if it doesn’t?

Answer 6

IF positive:
• Light Chain Disease

IF negative

• Diabetic Nephropathy