Transplant kidney biopsy with stable normal sCr but elevated serum donor cell free DNA - an increasingly common indication for bx. Severe subclinical cellular rejection. Severe tubulitis (t3). #renalpath #pathtwitter #nephrology

When your post graduate student leaves something like this on completion of PG tenure you feel happy as a teacher and a feeling that you are giving best to your students

Let's change how the world views the pathologist. We are not the dour individual that sulks in the shadow of the medical profession. Ours is a vibrant world of colour. From Dr CT Kwa #pathologist #pathology #microscopy

It is good idea to grossly visualise the kidney biopsy after it has been done by nephrologist bedside. Hand lens can be helpful. Glomeruli are seen as red dots. Useful to just ensure you have sampled glomeruli before you submit it to nephropathologist

37 y female with hematuria, sub nephrotic range proteinuria and renal dysfunction. Low serum C4 , Serum C3 normal. Biopsy images attached. What special test could be advised to confirm diagnosis. What will be seen on EM?

75 yr/f diagnosed with SLE in 2022,h/o oral ulcers,ANA +ve 1:640 No h/o joint pain,rash, photosensitivity Evaluation in 2025 shows sub-nephrotic proteinuria Urine routine protein 1+, RBC -1-2 HE PAS Silver IF clue. IHC throws a surprise. Diagnosis ? Identify the diagnostic IHC

Doesn't get much worse than this. One of the worst cases of vascular rejection I have seen. v-3 lesions. (grade III cellular rejection). #renalpath#nephrology #PathTwitter

PGNMID in adolescents is clinicopathologically similar to adults but with more related to viral infection. Clone targeted therapy should be started after infection is considered kireports.org/article/S2468-…

Lupus nephritis (native) : classic immune thrombi, wire loop lesions & endocapillary cells++. Extra glomerular immune deposits : C1q( PTC/TBM staining). EM: “wire-loop” & PTC immune deposits. Read our 📝 on lupus in TX. Mayo Clinic Pathology Mayo Clinic Nephrology Mayo Clinic Transplant KIReports

Dual Occurrence of DNAJB-9 Positive Fibrillary Glomerulonephritis and Diffuse Lupus Nephritis: A Unique Overlap Glomerulopathy kidneymedicinejournal.org/article/S2590-…

Polarizable calcium oxalate microcrystals in a 16-year-old who ingested a small volume (<10 mL) of oxalic acid solution + grain alcohol (90% ethanol). The patient presented with a diffuse morbilliform rash, intermittent fevers, oral lesions and alterations in taste, and a 10-day

“Limited” biopsies often hold the 🔑 to the dx - pitfall of labeling . Here in a tiny bit of cortex are “crystals” within mononuclear CD68 positive cells. Great EM team captured dazzling crystals. IF pronase -be Crystal storing histiocytosis. DD: lymphoma

Polyoma virus 'crescents' in a case of BK nephropathy in a kidney transplant patient. SV40 demonstrates parietal epithelial cell positivity on deeper levels. BK viremia >3 million recently. #renalpath #pathtwitter #nephrology

Kidney transplant in patients with C3 glomerulopathy academic.oup.com/ckj/article/18…

Humans have evolved an efficient complement system to protect from microorganisms The fetus is a hemiallograft that triggers complement

Case of insiduous advanced presentation of IgAN/TMA as the first diagnosis. Young pt with AKI and hypertensive urgency. Bx with extensive chronic changes (>70% GS, IFTA), rare fibrocellular crescent, 4+ IgA by IF, and focal TMA. #renalpath #nephrology #PathTwitter

Kidney bx for RPGN. MPO ANCA +++ Temporal heterogeneity of crescents seen. Fibrinogen highlights a crescent (grey arrow). IgG shows trace to 1+ deposits in glomerulus. Remember its PAUCI immune crescentic GN - we can have “some” immune deposits!! What do you think?

Some well formed "eye lashes" on these capillary loops in a case of AL-amyloidosis. Podocytes getting skewered by the spicules in the EM. #renalpath #pathtwitter #nephrology.