Great paper on the spectrum on kidney biopsy findings in pt's with history of methamphetamine use kireports.org/article/S2468-… Jean Hou, MD Grace Choung, MD 박영이 Cynthia Nast, MD #renalpath #PathTwitter

#Myeloperoxidase -Associated #MembranousNephropathy in Anti-Neutrophil Cytoplasmic Antibody-Associated #ANCA Glomerulonephritis

#VisualAbstract by Denisse Arellano

kireports.org/article/S2468-…

Low grade DNAJB-9 positive fibrillary GN hiding in a case of severe diabetic nephropathy. Clue was the smudgy IgG staining on IF. No definite fibrils in EM (probably due to segmental distribution). Probably mostly incidental finding in this case. #renalpath #pathtwitter

FPE in Focal segmental glomerulosclerosis (FSGS) teaching points:

Primary FSGS: Diffuse FPE + nephrotic syndrome (NS), 1/3 ? anti nephrin antibody

Secondary FSGS: Minimal/segmental FPE + proteinuria but not NS

Genetic FSGS: Variable FPE +/- NS. Secondary causes of FSGS absent

Genetic FSGS can show variability in foot process effacement (FPE).

A young patient with steroid resistant nephrotic syndrome.

Bx:
LM: FSGS
IF: Negative
EM: Was expecting diffuse FPE, but foot processes are well preserved.

Genetic: TRCP6 mutation

Dx: FSGS, secondary to TRCP6

A particularly robust case of light chain deposition disease.
The fine light chain deposits along the glomerular basement membranes mimic electron-dense transformation as they are so densely packed together.

#DiagnoseThis What would be your leading Dx and subtype based on the Congo red image below showing deposition predominately in the cortex of a Hispanic patient?

A Case of Diabetes with dyslipidemia, hyperkalemia presented with RPRF. Biopsy showed granular to globular, string of beads appearance stained with IHC myoglobin on background changes of diabetic nephropathy.

Renal Amyloidosis ~ #RenalPath #kidney

Collagenofibrotic glomerulopathy
Rare & involves abnormal type 3 collagen deposition. Most reported cases are sporadic & in adults with proteinuria, hematuria, & renal failure; though clinical manifestation & progression are variable. #renalpath
(1/2)

Classic example: Architectural and cellular features of Papillary thyroid carcinoma (Pap stain) #cytology #cytopathology

Well developed peritubular capillary basement membrane multilayering in a case of chronic active AMR. C4d+. #renalpath #pathtwitter

🔬We have an unexpected opening for our GYN Pathology fellowship that starts July 1, 2024. Please click the link for more details:uclahealth.org/sites/default/…

#gynpath #pathology #path2path #PathTwitter #pathfellowship #whyucla

When tiny worlds collide... A teeny TRI (tubuloreticular inclusion) in this patient with AA amyloidosis and HIV infection. TRI in center, amyloid fibrils to the right.

Nice example of dense deposit disease with MPGN pattern of injury. C3 only staining. Highly electron dense intramembranous deposits. #renalpath #pathtwitter

Unexpected in pt with HIV: High suspicion required to pick up IgG4-RD

LM: extensive interstitial inflammation & fibrosis.
Numerous cells +++ for both IgG & IgG4.

Background fibrosis was a giveaway.

Dx: IgG4-related renal disease

45-yr with HIV, under control, rise in Cr to 4.

Checkpoint Checkmate: I've seen a few of these cases recently, checkpoint inhibitor related interstitial nephritis. Unfortunately, there is advanced tubulointerstitial scarring in this patient.

Renal Pathology - CAP Subspecialty Series. #RenalPath #PathTwitter #PathX #Pathology