Glomerular Dz Flashcards
Oval fat bodies/fatty casts
Seen in Nephrotic Syndrome
Fat bodies and fatty casts; appear as “maltese cross” under polarized light; seen in nephrotic syndrome
Describe glomerular vs extraglomerular hematuria.
Normular glomerulus
EM of a normal glomerulus
Mesangial proliferation (part of hypercellularity) seen in Acute Glom Dz.
* Endothelial cell proliferation (part of hypercellularity) see in acute glom. dz
What are the arrows pointing to?
Exudation: leukocyte infiltration of the glomerulus, sign of inflammation, seen in acute glomerular dz
Exudation–leukocyte (inflammatory cells) infiltration of glomerulus in acute glom dz
crescents–epithelial cell proliferation (extracapillary); part of hypercellularity seen in acute glomerular dz
Crescents—extracapillary epithelial cell proliferation; seen in acute glomerular dz
Tuft necrosis; glomerular capillary necrosis; seen in acute glomerular dz
What lesion distribution patterns are shown these images?
Left = focal, segmental (affects only part of a glomerulus, and not all glomeruli affected)
Right = focal, global (affects entire glomerulus, but only some glomeruli)
EM of an RBC squeezing through broken GBM; results in dysmorphic RBC’s (on urine sed) characteristic of glomerular hematuria
RBC’s in kidney tubules; seen in glomerular hematuria
RBC cast; sign of glomerular hematuria (pathoneumonic for Nephritic syndrome and RPGN)
Name the types of deposits in A, C, & D. What is B?
Electron-dense Immune complex deposits seen on EM
GBM Sclerosis seen on EM; seen in chronic glomerular dz.
See normal GBM on EM below
Mesangial sclerosis seen in chronic glomerular dz
Glomerularsclerosis (nodular sclerosis) seen in DM; sign of chroni**c glomerular dz
Segmental sclerosis seen in chronic glomerular dz
Segmental sclerosis and tuft adhesions seen in chronic glomerular dz
Fibrous crescent (remnant of cellular crescent); seen in chronic glomerular dz
Global glomerulosclerosis; seen in chronic glomerular dz
EM of normal glomerulus
Membranous GM; characterized by a thickened, “tram tracks” BM; “spikes” on BM due to fixed Ag-Ab complexes on basolateral surfaces of podocyte foot processes
Membranous GM; characterized by a thickened, “tram tracks” BM; “spikes” on BM due to fixed Ag-Ab complexes on basolateral surfaces of podocyte foot processes
Membranous GM on EM; characterized by a thickened, “tram tracks” BM; “spikes” on BM due to fixed Ag-Ab complexes on basolateral surfaces of podocyte foot processes
Membranous GN on IF; looks like “ribbon-like” GBM
Minimal Change Dz; see podocyte effacement on EM, but looks normal on LM!
Focal Segmental Glomerular Sclerosis
Nodular glomerulosclerosis; seen in diabetic nephropathy
Nodular glomerulosclerosis seen on EM; seen in DM nephropathy
Nodular glomerulosclerosis seen in DM nephropathy
IgA Nephrophathy; see immune complexes in mesangium
Globally sclerotic glomeruli seen in IgA Nephropathy
blue lymphocytes in area of fibrosis and atrophy; seen in IgA Nephropathy
Fibrous crescents seen in IgA nephropathy
Cellular crescents (yellow arrow) and global glomerulosclerosis (blue stars) seen in IgA Nephropathy
IgA complexes seen on IF; IgA nephropathy
IgA immune complexes in mesangium on EM; seen in IgA nephropathy
subepithelial humps and WBC in capillary lumen seen on EM; seen in post-infections glomerulonephritis
subepithelial humps seen on EM; indicates Post-Infectious GN
IgG deposits seen in IF; many polys/proliferations seen in PIGN
Big Ig/Complement deposits that crowd bowman’s capsule; seen in Lupus nephritis
crescents (cell proliferation) seen in Lupus Nephritis
numerous electron-dense deposits seen on EM (subendothelial, subepithelial, and mesangial).
Full House of Ig and Complement on IF; Lupus Nephritis
Crescentic GN; seen RPGN (including Anti-GBM, ANCA/Pauci-immune, and immune complex dzs).
Linear IgG deposits seen in IF; Anti-GBM (Good Pasture’s)
pin-pt hemorrhages, “flea-bitten” appearance of kidney; seen in Anti-GBM dz
What tissue is this and what dz process?
Amyloidosis in the heart
What tissue is this and what dz process?
Amyloidosis in the liver
Amyloidosis in the liver stained with Congo Red
Amyloidosis of the glomerulus; seen with “apple green birefringence” under polarized light (congo red stain)
Familial amyloidotic neuropathy; TTR amyloid; a type of systemic amyloidosis
Senile systemic amyloidosis; amyloid protein is TTR and dominant distribution is in the heart.
Amyloid plaques seen in Alzheimers pt
Amyloidosis seen in Islets of Langerhans of pt’s with Type II DM
Gross amyloidosis of kidney; kidney has glistening appearance
“Sago Spleen” amyloidosis
Lardaceous spleen amyloidosis
Amyloidosis of liver; first deposits are in space of Disse; with progression see encroachment on parenchyma and sinusoids, leading to pressure atrophy of hepatocytes
Cardiac amyloidosis; seen in systemic amyloidosis and senile amyloidosis; deposits are between myocardial cells, leads to pressure atrophy.
