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Normal glomerulus, light microscopy in trichrome stain. Blue - glomerular truft and blue BM of cap wall . ure1

Normal glomerulus - EM; L = lumen, e - endothelial cell body; M=mesengial cell; F= foot processes; p = podocyte; U = urinary space

normal glomeruli - Glomerular filter EM, Capillary Lumen, Urinary space, Fenestration; Endothelial cell; BM of laminar rara and lamina densa; slite diaphragm, Foot processes

Minimal change disease - Normal glomerulus in LM and IF

Minimal change glomerulopathy - light micrograph shows no abnormality

Minimal change disease - Foot process fusion in EM. Loss of GBM negative charge causes selective loss of albumins, but not globulins

Minimal change GN - podocyte has extensive effacement of foot processes

Membranous glomerulopathy - diffuse capillary and GBM thickening

Membranous glomerulopathy - silver stain - granularity shows immune complexes

Membranous glomerulopathy - granular subepithelial IgG+

Membranous glomerulopathy 3 - granular subepithelial IgG+

Membranous glomerulopathy - accumulation of dense immune complex IgG on subepithelial side of BM

Membranous glomerulopathy 2 - Diffuse thickening of capillary wall, no hypecellularity

Membranous glomerulopathy 4. MCC adut nephrotic s/d , a/w HBV

Focal segmental glomerulosclerosis - only part of glomeruli involved. a/s HIV and blacks

Focal segmental glomerulosclerosis - trichome stain - mesangial matrix and cell increased

- high recurrence rate (50% even after transplant)
- can recur immediately after kidney transplantation (indicates circulating factor responsible for disease)

Focal segmental glomerulosclerosis - IF - IgM deposition in areas of sclerosis

Focal segmental glomerulosclerosis - mesangial sclerosis, lipid vacuoles

Focal segmental glomerulosclerosis - only part of glomeruli involved 2

Focal segmental glomerulosclerosis - only part of glomeruli involved

IgA nephropathy (Berger's d/s) - mesangial proliferation and hypercellularity

IgA nephropathy (berger's d/s, a/w HSP) - granular IgA based IC deposits in mesangium

IgA nephropathy (Berger's d/s) - mesangial cell dense deposits (on subendothelial side)

Poststreptococcal glomerulonephritis - VERY cellular glomerulus. "lumpy-bumpy appearance"

Poststreptococcal glomerulonephritis - granular appearance d/t IgG, IgM and C3 depositions in GBM and mesangium

Poststrepglomerulonephritis -subepithelial coarsely granular lumpy bumpy

Poststrep glomerulonephritis - endothelial cell with lumps, bumps in subepithelial

Poststreptococcal glomerulonephritis - large subepith granules

Poststreptococcal glomerulonephritis - seen in children 2-3 weeks after strep

Membranoproliferative glomerulonephritis - lobular pattern and hypercellular, cannot see open capillary loops

increased lobulation of glomerulus

Membranoproliferative glomerulonephritis - PAS shows BM duplication (tram track) and mesangial hypercellularity

Membranoproliferative glomerulonephritis - granular IgG deposition in mesangium and subendothelium

increased lobulation of glomerulus

Membranoproliferative glomerulonephritis type `- subendothelial layer - cells try to cover it to make tram tracks

BM duplication and subendothelial electron-dense deposits (blue arrows)

Membranoproliferative glomerulonephritis - type II - very dense, large crescent shape of deposit

Band-like subendothelial deposition of C3

Membranoproliferative glomerulonephritis - uncontrolled activation of complement

Cryoglobulinemia (cryoglobulin because Ab to Ab to Ag) - seen in Membranoproliferative glomerulonephritis

Rapidly Progressive (crescent) GN - hypercellular glomerulus, crescents, fibrin deposition and collapse of glom tuft

Severe injury causes glomerular tuft fragmentation and and a break in capsule (double arrow)

Rapidly Progressive (crescent) - Proliferation of parietal epithelial cells lining Bowman's Capsule and mononuclear cell infiltrate. There are prominent fibrin strands btwn the cell layers in the crescents.

Amyloidosis - apple green firengence on congo red stain with polarized light

Amyloidosis - apple green

Amyloidosis - fibrils deposited -> mesangial expansion

Amyloidosis 2

Amyloidosis - Congo red stain of amyloid

Amyloidosis - not as PAS pos as diabetic

Amyloidosis - expansion of mesangium by amyloid fibrils that are 8-10nm in diameter. Individual fibrils within each plane interlace to form groups of fibers in parallel.

Amyloidosis - amyloid deposition not as PAS positive as diabetoc

Amyloidosis - Amorphous acellular meterial expands mesangial areas and obstructs glomerular capillaries.

Diabetic nephropathy - Pseudo-linear peripheral IgG and Albumin deposits and nodular mesangial IgM + C3 deposits

Diabetic nephropathy - advanced KW disease (nodular expansion of PAS positive, mesangial matrix)

Diabetic nephropathy - IgG and IgM and albumin sticking in blood vessels

Deposits of amorphous material in vessels (arteriosclerosis)

Diabetic nephropathy - Kimmselstiel-Wilson nodules (nodular expansion of PAS positive, mesangial matrix)

Diabetic nephropathy - nodular deposition of acellular material

Diabetic nephropathy - thickened BM,
matrix-expanded mesangium

Diabetic nephropathy - thickened capillary loop

Diabetic nephropathy

1. Capillary Basement Membrane Thickening
2. Diffuse Mesangial Sclerosis (PAS+ staining)
3. Nodular Glomerulosclerosis
4. Hyalinizing Arteriosclerosis (worst in the hilar vessels)

Dysmorphic RBC - nephritic syndrome

Goodpasture's syndrome (lung involvement)

Lupus nephropathy - granular mesangial IgG, IgM, and complement deposits

corner looks like its looped for lupus

Lupus nephropathy - mesangial proliferation characteristic of all classes of lupus nephritis.

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