Superpage - Images
Kidney nontumor / medical renal

Authors: Mohammed Akhtar, M.D., Shreeram Akilesh, M.D., Ph.D., Sam T. Albadri, M.B.Ch.B., M.Sc., Nicole K. Andeen, M.D., Shelby Barnachea, B.S., Peter Boor, M.D., Ph.D., Amanda Breitbarth Borgen, M.D., Evelyn T. Bruner, M.D., Corynne Caballero, M.D., Michael Carstens, M.D., Ph.D., Giorgio Cazzaniga, M.D., Rana Chakrabarti, M.D., M.P.H., Alana D. Dasgupta, M.D., Dale Davis, M.D., M.A., Alexander J. Gallan, M.D., Santhi Ganesan, M.D., Ian W. Gibson, M.B.Ch.B., M.D., Aubre Gilbert, M.D., Rajib K. Gupta, M.D., Dalia Y. Ibrahim, M.D., M.Sc., Kevin Jankowski, Ph.D., Saira Javeed, M.B.B.S., M.Phil., Husam Jum'ah, M.D., Saman Karimi, M.D., M.S., Anam Khan, M.B.B.S., Vanderlene Liu Kung, M.D., Ph.D., Vincenzo L'Imperio, M.D., Kriselle Lao, M.D., Ana Belén Larqué, M.D., Ph.D., Christine M. Lee, M.D., Zhengchun Lu, M.D., Ph.D., Miao (Vivian) Lu, M.D., Aisha Memon, M.B.B.S., Alexei Mikhailov, M.D., Ph.D., Muhammad Khurram Minhas, M.B.B.S., Rusella Mirza, M.D., Ph.D., Khaled A. Murshed, M.D., Tibor Nadasdy, M.D., Paisit Paueksakon, M.D., Fenghua Peng, M.D., Ph.D., Nat Pernick, M.D., Deepak K. Pruthi, M.D., M.Sci.-T.S., Jian-Hua Qiao, M.D., Robyn C. Reed, M.D., Ph.D., Monika Roychowdhury, M.D., Arzu Sağlam, M.D., Alireza Samiei, M.D., Nikhil Sangle, M.D., Anjali A. Satoskar, M.D., Suman Setty, M.B.B.S., Ph.D., Anthony Sisk, D.O., Maria Fernanda Soares, M.D., Ph.D., Noheir M. Taha, M.B.B.Ch., M.D., Maria Tretiakova, M.D., Ph.D., Ramya Krishna Velagapudi, M.D., M.H.A., Saskia von Stillfried, M.D., Sittipong Wangsawibul, M.D., Astrid Weins, M.D., Ph.D., Haiyan Zhang, M.D., Ph.D., Mandolin S. Ziadie, M.D., Jonathan E. Zuckerman, M.D., Ph.D., Chunlai Zuo, M.D., M.S.
Editorial Board Members: Nicole K. Andeen, M.D., Bonnie Choy, M.D., Maria Tretiakova, M.D., Ph.D., Jonathan E. Zuckerman, M.D., Ph.D.
Editor-in-Chief: Debra L. Zynger, M.D.

Copyright: 2003-2024, PathologyOutlines.com, Inc.

Renal related: Jobs, Fellowships, Conferences, Cases, CME, Board Review

Related chapters: Adrenal gland, Kidney tumor

Editorial Board oversight: Jonathan E. Zuckerman, M.D., Ph.D. (last reviewed December 2024), Nicole K. Andeen, M.D. (last reviewed December 2023)

Acquired cystic kidney disease
Gross images

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Left: acquired cystic disease; right: with renal cell carcinoma

Renal transplant 12 years prior

With central scar


Active / chronic active antibody mediated rejection
Diagrams / tables

Images hosted on other servers:
C4d deposition

Mechanisms of donor specific ABMR

Gross images

Contributed by Arzu Sağlam, M.D.
Active antibody mediated rejection

Active antibody mediated rejection

Microscopic (histologic) images

Contributed by Arzu Sağlam, M.D.
Peritubular capillaritis and glomerulitis

Peritubular capillaritis and glomerulitis

Peritubular capillaritis

Peritubular capillaritis

Severe peritubullary capillaritis (ptc3)

Severe peritubullary capillaritis (ptc3)

Peritubullary capillaritis, neutrophils

Peritubullary capillaritis, neutrophils

Peritubullary capillaritis

Peritubullary capillaritis

Glomerulitis

Glomerulitis


Peritubullary capillaritis, JMS stain Peritubullary capillaritis, JMS stain Peritubullary capillaritis, JMS stain

Peritubullary capillaritis, JMS stain

Peritubullary capillaritis, PAS stain

Peritubullary capillaritis, PAS stain

Transplant glomerulopathy Transplant glomerulopathy

Transplant glomerulopathy


Chronic active ABMR

Chronic active ABMR

Transplant glomerulopathy and glomerulitis

Transplant glomerulopathy and glomerulitis

Transplant glomerulopathy Transplant glomerulopathy

Transplant glomerulopathy

Chronic active ABMR, JMS stain

Chronic active ABMR, JMS stain


Transplant glomerulopathy, JMS stain Transplant glomerulopathy, JMS stain

Transplant glomerulopathy, JMS stain

C4d staining, IHC C4d staining, IHC C4d staining, IHC

C4d staining, IHC


Acute / chronic active T cell mediated rejection
Gross images

Contributed by Arzu Sağlam, M.D.
Chronic active TCMR, allograft nephrectomy

Chronic active TCMR, allograft nephrectomy

Microscopic (histologic) images

Contributed by Arzu Sağlam, M.D.
Interstitial inflammation Interstitial inflammation Interstitial inflammation

Interstitial inflammation

Interstitial inflammation - macrophage predominant

Interstitial inflammation - macrophage predominant

Tubulitis

Tubulitis

Severe tubulitis

Severe tubulitis


Tubulitis, PAS stain Tubulitis, PAS stain Tubulitis, PAS stain

Tubulitis, PAS stain

Tubulitis, JMS stain Tubulitis, JMS stain

Tubulitis, JMS stain

Intimal edema and lymphocyte margination

Intimal edema and lymphocyte margination


Interstitial hemorrhage

Interstitial hemorrhage

Intimal arteritis Intimal arteritis

Intimal arteritis

Intimal arteritis, JMS stain

Intimal arteritis, JMS stain

Transmural arteritis

Transmural arteritis

Transmural arteritis and fibrinoid necrosis

Transmural arteritis and fibrinoid necrosis


Acute allograft glomerulopathy

Acute allograft glomerulopathy

Acute allograft glomerulopathy JMS stain

Acute allograft glomerulopathy JMS stain

Severe acute allograft glomerulopathy

Severe acute allograft glomerulopathy

i-IFTA

i-IFTA

Tubulitis of atrophic tubuli

Tubulitis of atrophic tubuli

Tubulitis of atrophic tubuli, JMS stain

Tubulitis of atrophic tubuli, JMS stain


Preserved renal parenchyma

Preserved renal parenchyma

Transplant arteriopathy Transplant arteriopathy Transplant arteriopathy Transplant arteriopathy

Transplant arteriopathy

Transplant arteriopathy and IFTA, MTC stain

Transplant arteriopathy and IFTA, MTC stain


Intimal foam cells in small arteryn Intimal foam cells in small artery

Intimal foam cells in small artery

Intimal foam cells and fibrosis in small artery, MTC

Intimal foam cells and fibrosis in small artery, MTC


Acute postinfectious glomerulonephritis
Diagrams / tables

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Missing Image

Diagram of electron and light microscopy

Microscopic (histologic) images

Contributed by Aisha Memon, M.B.B.S.

Diffuse global proliferative appearance

Global proliferative appearance

Cellular crescent formation

Mesangial hypercellularity

Mesangial hypercellularity on periodic acid-Schiff

Electron microscopy images

Contributed by Jonathan E. Zuckerman, M.D., Ph.D.
Endocapillary neutrophil

Endocapillary neutrophil

Subepithelial hump-like deposits Subepithelial hump-like deposits Subepithelial hump-like deposits

Subepithelial hump-like deposits

Mesangial deposits

Mesangial deposits

Mesangial notch/hinge region deposit

Mesangial notch / hinge region deposit


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Subepithelial humps Subepithelial humps

Subepithelial humps


Acute pyelonephritis
Radiology images

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(a) CT: gas in psoas muscle (b) disappearance of gas after treatment

(a) CT: gas in
psoas muscle
(b) disappearance of
gas after treatment

CT: gas in renal parenchyma, and pararenal space

CT: gas in renal parenchyma, and pararenal space

Ultrasound: "dirty" acoustic shadows (gas)

Ultrasound: "dirty" acoustic shadows (gas)

CT: gas in kidney and IVC

CT: gas in kidney and IVC

Gross images

Contributed by Jian-Hua Qiao, M.D.
Bisected kidney

Bisected kidney

Detached renal capsule

Detached renal capsule

Close view

Close view

Gas filled cysts Gas filled cysts

Gas filled cysts



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Areas of papillary necrosis

Areas of papillary necrosis

Microscopic (histologic) images

Contributed by Jian-Hua Qiao, M.D.
Acute inflammation

Acute inflammation

Neutrophil casts

Neutrophil casts

Abscess

Abscess

Necrotic renal cortex

Necrotic renal cortex

Gas filled cysts

Gas filled cysts


Acute tubular necrosis
Diagrams / tables

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Inflammation and different stages of AKI

Pathophysiology of hypoperfusion related AKI

Microscopic (histologic) images

Contributed by Dale Davis, M.D., M.A.
Attenuated tubules with casts

Attenuated tubules with casts

Cell sloughing

Cell sloughing

Cytoplasmic blebbing

Cytoplasmic blebbing

Loss of brush border

Loss of brush border

Frank necrosis

Frank necrosis

Electron microscopy images

Contributed by Colleen Ford
Lumen with cellular debris

Lumen with cellular debris

Aberration of basement membrane

Aberration of basement membrane

Videos

Overview of intrarenal acute kidney injury


Adenovirus
Microscopic (histologic) images

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Missing Image

Various images

Missing Image

Adenovirus immunoperoxidase stain


Alport syndrome and thin basement membrane lesion
Microscopic (histologic) images

Contributed by Alexei Mikhailov, M.D., Ph.D.
Early Alport syndrome

Early Alport syndrome

Early chronic changes

Early chronic changes

Focal segmental glomerular scarring

Focal segmental glomerular scarring

Foam cells, Alport syndrome

Foam cells, Alport syndrome

Electron microscopy images

Contributed by Alexei Mikhailov, M.D., Ph.D.
Microvillus transformation

Microvillus transformation

Characteristic changes

Characteristic changes

More advanced changes

More advanced changes

Thin basement membrane disease

Thin basement membrane disease

Alport-like changes

Alport-like changes


Analgesic nephropathy
Microscopic (histologic) images

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Missing Image

Various images


Anatomy & histology
Diagrams / tables

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Vertical section

Normal glomerulus

Vessels surrounding glomeruli and tubules


Relation to other organs



Juxtaglomerular apparatus

Renal column

Vessels supplying tubule

Vessels surrounding glomeruli and tubules

Gross images

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Fetal kidneys at 25 weeks gestation

Infant kidney with fetal lobulations

Normal adult kidney

Microscopic (histologic) images

Contributed by Grigory Demyashkin, M.D., Ph.D.

6 - 8 week embryo:

Metanephros; adrenal gland medulla

Metanephros; colon; pancreas

Small intestine; stomach;
gonad and kidney primary
(mesonephros); symphysis

Final kidney (metanephros), renal corpuscle

Final kidney (metanephros), renal corpuscle, collecting ducts

Metanephros; adrenal gland medulla


Final kidney (metanephros)

Final kidney (metanephros);
liver; gonad & kidney
primary (mesonephros);
symphysis

Final kidney (metanephros)

Adrenal gland, medulla & final kidney (metanephros)



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Glomerular capillary loops are thin and delicate

Basement membranes
of glomerular
capillary loops and
tubular epithelium

Collecting duct: brush border

Juxtaglomerular apparatus and macula densa

Medullary rays


Anti-brush border antibody disease / anti-LRP2 nephropathy
Microscopic (histologic) images

Contributed by Alexander J. Gallan, M.D.
Missing Image

Tubular injury

Electron microscopy images

Contributed by Alexander J. Gallan, M.D.
Missing Image

TBM deposits

Missing Image

Segmental glomerular subepithelial deposits


Anti-GBM nephritis
Microscopic (histologic) images

Contributed by Ana Belén Larqué, M.D., Ph.D.

Cellular crescents

Fibrinoid necrosis

Disruption of Bowman capsule

Electron microscopy images

Images hosted on other servers:

Extracapillary crescent

Videos

GBM, Alport and anti-GBM


Arterionephrosclerosis
Gross images

Contributed by Husam Jum’ah, M.D.
Renal cortical surface with granularity

Renal cortical surface with granularity



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Missing Image

Characteristic granular appearance

Microscopic (histologic) images

Contributed by Santhi Ganesan, M.D.
Global glomerulosclerosis

Global
glomerulosclerosis

Arterial medial thickening

Arterial medial thickening

Hyaline vascular changes

Hyaline vascular changes

Obsolescent glomerulus

Obsolescent glomerulus

Global glomerulosclerosis PAS

Global
glomerulosclerosis
PAS

Subintimal fibrosis trichrome

Subintimal fibrosis trichrome


Autosomal dominant polycystic kidney disease
Radiology images

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Angiogram

Angiogram

Gross images

Contributed by Debra L. Zynger, M.D.
Numerous cysts of varying sizes Numerous cysts of varying sizes Numerous cysts of varying sizes

Numerous cysts of varying sizes



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Cut surfaces showing variably sized cysts Cut surfaces showing variably sized cysts

Cut surfaces showing
variably sized cysts

Bilateral cystic kidneys within the retroperitoneum

Bilateral
cystic kidneys
within the
retroperitoneum

Enlarged kidney with variably sized cysts

Surface with many bulging cysts


Bivalved kidney revealing variably sized cysts

Bivalved kidney revealing variably sized cysts

With transplanted kidney

With transplanted kidney

Compared to normal kidney

Compared to normal kidney

Hemorrhagic infarct with rupture

Hemorrhagic infarct with rupture

Microscopic (histologic) images

Contributed by Anthony Sisk, D.O.
Multiple expansile cysts

Multiple expansile cysts

Cuboidal to flat epithelium

Cuboidal to flat epithelium

Papillary projections

Papillary projections

Microscopic to macroscopic cysts

Microscopic to macroscopic cysts

Cyst formation within papillae

Cyst formation within papillae

Extensive tubulointerstitial scar

Extensive tubulointerstitial scar


Autosomal recessive polycystic kidney disease
Gross images

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Markedly enlarged kidneys

Enlarged kidneys with persistent fetal lobation


Uniform distribution of small cysts

Small cysts in cortex and medulla

Renal surface shows small cysts

Spongy cut surface

Microscopic (histologic) images

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Radial arrangement of cysts with only rare glomeruli

Dilated collecting ducts in cortex and medulla

Immunostains

Associated congenital hepatic fibrosis


Bacterial infection related GN
Microscopic (histologic) images

Contributed by Vanderlene Liu Kung, M.D., Ph.D.
Missing Image

Glomerular capillary luminal neutrophils

Missing Image

Diabetic
glomerulosclerosis
with exudative GN

Missing Image

Cellular crescent

Electron microscopy images

Contributed by Vanderlene Liu Kung, M.D., Ph.D.
Missing Image

Intramembranous / subepithelial deposits


Benign renal cysts
Radiology images

Contributed by Deepak K. Pruthi, M.D., M.Sci.-T.S.
CT abdomen

CT abdomen

Contrast enhanced

Axial CT

Axial CT

Coronal CT

Coronal CT

Postsclerotherapy

Postsclerotherapy

Gross images

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Simple cyst of upper pole

Large cyst

Multiple, smooth renal cysts filled with serous fluid

Solitary, smooth
kidney cyst
(lower pole) filled
with serous fluid

Large cortical cysts with dark red blood

Microscopic (histologic) images

Contributed by Rana Chakrabarti, M.D., M.P.H.
Subcapsular cortical cyst Subcapsular cortical cyst

Subcapsular cortical cyst

Flattened cyst wall epithelium

Flattened cyst wall epithelium

Papillary excrescence

Papillary excrescence


Bile cast nephropathy
Gross images

Contributed by Jonathan E. Zuckerman, M.D., Ph.D.

Bile stained kidney

Microscopic (histologic) images

Contributed by Jonathan E. Zuckerman, M.D., Ph.D.

Bile casts in collecting ducts

Bile casts in proximal tubules

Hall bile stain

Cytology images

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Bile case


Biopsy
Diagrams / tables

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Dividing up core tissue
if no dissecting
microscope is present

Microscopic (histologic) images

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A: renal cortex with
round red glomeruli;
B: renal medulla
without glomeruli


BK virus / polyomavirus
Diagrams / tables

Images hosted on other servers:

Pathogenesis

Risk factors

Sources of infection

Microscopic (histologic) images

Contributed by Arzu Sağlam, M.D.
Well demarcated inflammation

Well demarcated inflammation

Tubulitis and intranuclear inclusions

Tubulitis and intranuclear inclusions

Polyomavirus score - pvl3

Polyomavirus score: pvl 3

Luminal casts and cytopathic changes Luminal casts and cytopathic changes

Luminal casts and cytopathic changes


Cytopathic changes

Cytopathic changes

Intranuclear basophilic granules

Intranuclear basophilic granules

Glomerular cytopathy

Glomerular cytopathy

Anti-SV40 antibody, immunohistochemistry

Anti-SV40 antibody, IHC

Cytology images

Contributed by Çisel Aydιn Meriçöz, M.D.
Decoy cells in urine cytology

Decoy cells in urine cytology

Electron microscopy images

Contributed by Jonathan E. Zuckerman, M.D., Ph.D.
IgG deposition

Viral particles

IgG deposition IgG deposition

Nuclear viral particles



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Polyomavirus Haufen

Polyomavirus Haufen and CISH staining

Tubular basement membrane deposits

Videos

Histomorphological characteristics of BK virus associated nephropathy in a transplant patient
by Dr. Arzu Sağlam


C3 glomerulonephritis / dense deposit disease
Microscopic (histologic) images

Contributed by Ana Belén Larqué, M.D., Ph.D.

Glomeruli with membranoproliferative pattern

  

Glomerulus with mesangial pattern

Glomerular basement membrane thickening

Double contour capillary walls

Electron microscopy images

Contributed by Ana Belén Larqué, M.D., Ph.D.

Linear electron dense deposits

Videos

Membranoproliferative GN


Calcineurin Inhibitor toxicity
Microscopic (histologic) images

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Various images

Allograft treated with cyclosporine A

Classic features of
calcineurin inhibitor
toxicity (cyclosporine
and tacrolimus)


Checkpoint inhibitor associated tubulointerstitial nephritis
Diagrams / tables

Images hosted on other servers:
Recommendations for management

Recommendations
for management

Mechanisms of immune checkpoint blockade

Mechanisms of immune checkpoint blockade

Treatment, recovery, rechallenge, recurrence rates

Treatment, recovery, rechallenge, recurrence rates

Microscopic (histologic) images

Contributed by Vincenzo L’Imperio, M.D. and Giorgio Cazzaniga, M.D.
Neutrophilic tubulitis

Neutrophilic tubulitis

Interstitial inflammatory infiltrate

Interstitial inflammatory infiltrate

Tubulitis, detail Tubulitis, detail

Tubulitis

Plasma cell rich infiltrate

Plasma cell rich infiltrate

Neutrophil rich infiltrate

Neutrophil rich infiltrate

Electron microscopy images

Contributed by Vincenzo L’Imperio, M.D. and Giorgio Cazzaniga, M.D.
Tubulitis

Tubulitis


Chronic kidney disease of unknown etiology (CKDu)
Microscopic (histologic) images

Contributed by Alexei Mikhailov, M.D., Ph.D.
IFTA with lymphocytic inflammation

IFTA with lymphocytic inflammation

Glomerulus in CKDu

Glomerulus in CKDu

Ischemic glomerulus in CKDu

Ischemic glomerulus in CKDu

Glomerular obsolescence in MEN

Glomerular obsolescence in MeN

MEN interstitial inflammatory infiltrate

MeN interstitial inflammatory infiltrate

Perihilar FSGS in CKDu

Perihilar FSGS in CKDu

Electron microscopy images

Contributed by Alexei Mikhailov, M.D., Ph.D.
MEN glomerular capillary

MeN glomerular capillary

MEN podocyte effacement

MeN podocyte effacement


Chronic pyelonephritis
Diagrams / tables

Contributed by Saman Karimi, M.D., M.S., Suman Setty, M.B.B.S., Ph.D. and Vijay Shankar, M.D.
Schematic of Chronic Pyelonephritis Schematic of Chronic Pyelonephritis

Schematic of chronic pyelonephritis

Microscopic (histologic) images

Contributed by Saman Karimi, M.D., M.S. and Suman Setty, M.B.B.S., Ph.D.
Renal cortical parenchyma with tubular atrophy and interstitial fibrosis, Masson Trichrome special stain

Interstitial chronic
inflammation,
tubular atrophy
and fibrosis

Interstitial chronic inflammation and periglomerular fibrosis

Interstitial chronic
inflammation and
periglomerular fibrosis

Renal tubular atrophy with luminal casts

Renal tubular atrophy with luminal casts

Renal tubular atrophy with luminal casts

Dense interstitial fibrosis

Videos

Overview of chronic pyelonephritis

Histological features of chronic pyelonephritis


Collagen type III glomerulopathy
Microscopic (histologic) images

Contributed by Joseph Grande, M.D., Ph.D.

Lobular mesangial expansion

Silver negative material deposits

PAS weak / negative deposits

Trichrome stains deposits blue



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Missing Image

Enlarged glomerulus with hyaline cap deposits

Lobular appearance

Missing Image

With Hodgkin's lymphoma

Missing Image

Silver stain

Congo red stain

Electron microscopy images

Contributed by Joseph Grande, M.D., Ph.D.

Extensive mesangial deposits

Higher power of subendothelial deposit



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Missing Image

Abundant subendothelial deposits of large fibers


Congenital anomalies-general
Diagrams / tables

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Renal hypoplasia

Gross images

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Agenesis - bilateral

Incomplete duplication

Horseshoe kidney

Microscopic (histologic) images

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Oligomeganephronic renal hypoplasia


Congenital nephrotic syndrome
Diagrams / tables

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Normal glomerular capillary and capillary wall

Normal glomerular capillary and capillary wall

Radiology images

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Enlarged and hyperechogenic kidneys by ultrasound Enlarged and hyperechogenic kidneys by ultrasound

Enlarged and hyperechogenic kidneys by ultrasound

Gross images

Contributed by Chunlai Zuo, M.D., M.S.
Enlarged pale kidney

Enlarged pale kidney

Microscopic (histologic) images

Contributed by Chunlai Zuo, M.D., M.S. and Jonathan E. Zuckerman, M.D., Ph.D.
Mesangial hypercellularity

Mesangial hypercellularity

Segmental glomerulosclerosis

Segmental glomerulosclerosis

Dilated proximal and distal tubes Dilated proximal and distal tubes

Dilated proximal and distal tubes

Cystic change and interstitial fibrosis

Cystic change and interstitial fibrosis

Electron microscopy images

Contributed by Jonathan E. Zuckerman, M.D., Ph.D.
Diffuse foot processes effacement Diffuse foot processes effacement

Diffuse foot processes effacement

Loss of slit diaphrams Loss of slit diaphrams

Loss of slit diaphrams


Mesangial hypercellularity

Mesangial hypercellularity

Endothelial cell blebs Endothelial cell blebs

Endothelial cell blebs


COVID-19 associated kidney injury
Microscopic (histologic) images

Contributed by Shreeram Akilesh, M.D., Ph.D.
Acute tubular injury

Acute tubular injury

Collapsing glomerulopathy

Collapsing glomerulopathy

Collapsing glomerulopathy and TMA

Collapsing glomerulopathy and TMA

Electron microscopy images

Contributed by Shreeram Akilesh, M.D., Ph.D.
Podocyte foot process effacement Podocyte foot process effacement

Podocyte foot process effacement

Effacement and TMA

Effacement and TMA


Crescentic glomerulonephritis overview
Microscopic (histologic) images

Contributed by Khaled A. Murshed, M.D., Noheir M. Taha, M.B.B.Ch., M.D. and Mohammed Akhtar, M.D.
Cellular crescent

Cellular crescent

Cellular crescent high magnification

Cellular crescent high magnification

Fibrin and parietal epithelial cell (PEC) proliferation

Fibrin and PEC proliferation

Cellular crescent with fibrin Cellular crescent with fibrin

Cellular crescent with fibrin

Fibrinoid necrosis

Fibrinoid necrosis


Capillary wall defect high magnification

Capillary wall defect high magnification

Bowman capsule defect

Bowman capsule defect

Circular crescent Circular crescent

Circular crescent

Monolayer parietal epithelial cell proliferation

Monolayer PEC proliferation

Early crescent

Early crescent


Fibrocellular crescent

Fibrocellular crescent

Fibrocellular fibrous crescent

Fibrocellular fibrous crescent

Fibrous crescent Fibrous crescent

Fibrous crescent

Anti-GBM disease

Anti-GBM disease

ANCA associated GN

ANCA associated GN

Electron microscopy images

Contributed by Khaled A. Murshed, M.D., Noheir M. Taha, M.B.B.Ch., M.D. and Mohammed Akhtar, M.D.
Electron dense deposits

Electron dense deposits

Pauci-immune

Pauci-immune


Cryoglobulinemia
Microscopic (histologic) images

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Cryoglobulin related glomerulonephritis

Electron microscopy images

Images hosted on other servers:

Various images


Diabetic kidney disease
Microscopic (histologic) images

Contributed by Khaled A. Murshed, M.D., Noheir M. Taha, M.B.B.Ch., M.D. and Mohammed Akhtar, M.D.

Capsular drop

Diffuse and nodular mesangial expansion

Lipohyaline cap

Thickening of Bowman capsule

Thickening of basement membrane


2 insudative lesions

Vascular hyalinosis

Segmental sclerosis, silver

Diffuse mesangial expansion, PAS

Afferent and efferent hyalinosis, PAS

Lipohyaline cap, PAS


Lipohyaline caps and nodules, PAS

Lipohyaline caps and nodules, silver

Microaneurysm, PAS

Microaneurysm, silver

Microaneurysm with nodule, silver

Microaneurysm with large nodule, silver


Nodular lesions, PAS

Electron microscopy images

Contributed by Khaled A. Murshed, M.D., Noheir M. Taha, M.B.B.Ch., M.D. and Mohammed Akhtar, M.D.

Diffuse thickening of GBM

Mesangium and GBM

Thickening of TBM

Videos

Diabetic nephropathy


Diffuse cortical necrosis
Gross images

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Missing Image

Various images

Microscopic (histologic) images

Images hosted on other servers:
Missing Image

Extensive focal cortical necrosis
with tubular necrosis and fibrin
thrombi in the glomerulus

Missing Image

Necrotic areas having ghost
outlines of glomeruli and tubules
with loss of cellular details

Videos

Histopathology kidney: diffuse cortical necrosis


Diffuse mesangial sclerosis
Microscopic (histologic) images

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Mesangial sclerosis

WT1 associated


Donor evaluation
Microscopic (histologic) images

Contributed by Nicole K. Andeen, M.D.

Case 1:

Normal glomerulus (FS)

Normal glomerulus
and adjacent intact
tubular parenchyma (FS)

Focal global GS in
subcapsular region
(H&E perm from FS)

Patches of tubular atrophy
& associated nonspecific
interstitial inflammation
(H&E perm from FS)

Low power with
no global GS (FS)

Low power with focal global GS
predominantly in subcapsular
region and patchy tubular atrophy
and IF (H&E perm from FS)



Case 2:

Focal global GS, ischemic glomeruli
with periglomerular fibrosis, adjacent
tubular atrophy, IF and nonspecific
interstitial inflammatory infiltrate (FS)

Focal global GS, adjacent
tubular atrophy and IF (FS)

Focal global and focal
and segmental GS, tubular
atrophy and IF (perm,
Jones silver stain)

Focal segmental GS, adjacent
arteriolar hyalinosis, tubular atrophy
and IF (perm, Jones silver stain)



Note: FS = frozen section, GS = glomerulosclerosis, IF = interstitial fibrosis, perm = permanent section

Dysplasia / hypoplasia / agenesis
Radiology images

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Multicystic renal dysplasia Multicystic renal dysplasia

Multicystic renal dysplasia

Multicystic renal dysplasia Multicystic renal dysplasia

Multicystic renal dysplasia


Unilateral renal agenesis Unilateral renal agenesis Unilateral renal agenesis

Unilateral renal agenesis

Gross images

Contributed by Robyn C. Reed, M.D., Ph.D.
Distorted shape, numerous cysts

Distorted shape, numerous cysts

Cysts, minimal remnant parenchyma

Cysts, minimal remnant parenchyma

Hypoplastic kidneys at autopsy

Hypoplastic kidneys at autopsy

Bilateral agenesis in situ

Bilateral agenesis in situ


 
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Multiple cysts of various sizes Multiple cysts of various sizes

Multiple cysts of various sizes

Multiple cysts of various sizes Multiple cysts of various sizes

Multiple cysts of various sizes


With small bladder

With small bladder

Cysts are smooth lined, no normal kidney tissue is apparent

Cysts are smooth
lined, no normal
kidney tissue
is apparent

With ipsilateral hypoplasia of ureter

With ipsilateral hypoplasia of ureter

Due to congenital urethral stenosis

Due to congenital urethral stenosis

Microscopic (histologic) images

Contributed by Robyn C. Reed, M.D., Ph.D.
Cysts in dysplasia

Cysts in dysplasia

Cysts and primitive tubules Cysts and primitive tubules

Cysts and primitive tubules

Tubule with mesenchymal collarette

Tubule with mesenchymal collarette


Metaplastic cartilage

Metaplastic cartilage

Cartilage and blastemal tissue

Cartilage and blastemal tissue

Primitive tubules Primitive tubules

Primitive tubules

Videos

Development of renal dysplasia

Development of renal agenesis; explanation of oligohydramnios sequence


Eosinophilic granulomatosis with polyangiitis (EGPA)
Microscopic (histologic) images

Contributed by Nicole K. Andeen, M.D., Patrick A. Maher, M.D., Juhi D. Mahadik, M.B.B.S., M.D. and Naziheh Assarzadegan, M.D. (Case #541)

Crescent

Arteritis

Medullary angiitis


Electron microscopy images

Contributed by Nicole K. Andeen, M.D.

Fibrin tactoids


Fabry disease
Diagrams / tables

Images hosted on other servers:
Pathophysiology of Fabry disease

Pathophysiology of Fabry disease

Clinical features of Fabry disease

Clinical features of Fabry disease

Radiology images
None
Clinical images

Images hosted on other servers:
Angiokeratomas in a patient with Fabry disease Angiokeratomas in a patient with Fabry disease

Angiokeratomas in a patient with Fabry disease

Microscopic (histologic) images

Contributed by Ramya Krishna Velagapudi, M.D., M.H.A.
Inclusions - toluidine blue

Inclusions (toluidine blue)

Foamy appearing podocytes - Jones silver

Foamy appearing podocytes (Jones silver)

Electron microscopy images

Contributed by Paisit Paueksakon, M.D.
Inclusions Inclusions

Inclusions



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Lamellated inclusions in podocytes

Lamellated inclusions in podocytes

Myelin-like inclusions in podocyte cytoplasm

Myelin-like inclusions in podocyte cytoplasm

Electron microscopic changes in Fabry disease

Myelin figures in glomerular epithelial cells

Lamellated inclusions in glomerulus

Lamellated inclusions in glomerulus

Inclusions in different cells

Inclusions in different cells

Videos

Washington University in St. Louis renal pathology teaching series: Fabry disease


Fabry disease
Microscopic (histologic) images

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Missing Image

Various images including EM

Missing Image

Global sclerosis,
segmental sclerosis
with moderate
interstitial fibrosis

Electron microscopy images

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Missing Image

Electron dense lamellar
inclusion bodies in
cytoplasm of skin
fibroblasts

Fibrillary glomerulonephritis
Microscopic (histologic) images

Contributed by Alana D. Dasgupta, M.D., Mandolin S. Ziadie, M.D. and Nicole K. Andeen, M.D.
Normocelluar glomerulus with mesangial expansion Normocelluar glomerulus with mesangial expansion

Normocelluar glomerulus with mesangial expansion

Active cellular crescent Active cellular crescent

Active cellular crescent

Thick GBM and expanded mesangium Thick GBM and expanded mesangium

Thick GBM and expanded mesangium


Periodic acid-Schiff Periodic acid-Schiff

Periodic acid-Schiff

Jones methenamine silver Jones methenamine silver

Jones methenamine silver

DNAJB9 DNAJB9

DNAJB9


Trichrome

Trichrome

Electron microscopy images

Contributed by Alana D. Dasgupta, M.D. and Mandolin S. Ziadie, M.D.
GBM and mesangium

GBM and mesangium

GBM

GBM

Mesangium

Mesangium

Measurements of fibrils

Measurements of fibrils

GBM and mesangial expansion

GBM and mesangial expansion


Randomly arranged fibrils Randomly arranged fibrils

Randomly arranged fibrils

Randomly arranged fibrils Randomly arranged fibrils

Randomly arranged fibrils



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Fibrillary deposits in mesangium

Randomly arranged fibrils


Fibronectin glomerulopathy
Microscopic (histologic) images

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Missing Image

Eosinophilic material in mesangial regions

Missing Image

Immunoelectron microscopy with anti-fibronectin

Missing Image

Glomeruli show massive deposits of a homogeneous structureless

Missing Image

Massive flooding of the glomerulus with fibronectin

Electron microscopy images

Images hosted on other servers:
Missing Image

Enlargement of glomerular basement membrane and massive mesangial electron-dense deposits


Focal segmental glomerulosclerosis-general
Diagrams / tables

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Primary and secondary FSGS

Primary and secondary FSGS

Sclerosis development in FSGS

Sclerosis development in FSGS

Microscopic (histologic) images

Contributed by Vincenzo L’Imperio, M.D. and Giorgio Cazzaniga, M.D.
Segmental sclerosis with adhesion

Segmental sclerosis with adhesion

Segmental sclerosis at the tubular pole Segmental sclerosis at the tubular pole

Segmental sclerosis at the tubular pole


Segmental sclerosis with collapse Segmental sclerosis with collapse

Segmental sclerosis with collapse

Perihilar segmental sclerosis with hyalinosis Perihilar segmental sclerosis with hyalinosis

Perihilar segmental sclerosis with hyalinosis

Electron microscopy images

Contributed by Vincenzo L’Imperio, M.D. and Giorgio Cazzaniga, M.D.
Complete foot process effacement

Complete foot process effacement

Foot process effacement and microvillous transformation

Foot process effacement and microvillous transformation

GBM lamellation

GBM lamellation


FSGS-collapsing variant
Microscopic (histologic) images

Contributed by Nicole K. Andeen, M.D.

Collapse of the glomerular tuft and prominence of the overlying epithelial cells, Jones stain

PAS

Trichrome



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Collapsed glomerulus

With sickle cell disease

Various images

Electron microscopy images

Contributed by Nicole K. Andeen, M.D.

Podocyte foot process effacement


Granulomatosis with polyangiitis
Microscopic (histologic) images

Contributed by Anjali A. Satoskar, M.D.
Segmental necrotizing lesion Segmental necrotizing lesion

Segmental necrotizing lesion

Red blood cell (RBC) casts

Red blood cell (RBC) casts

Global necrotizing lesion Global necrotizing lesion

Global necrotizing lesion


Global necrotizing lesion

Global necrotizing lesion

Global necrotizing lesion with destroyed Bowman capsule

Global necrotizing
lesion with
destroyed
Bowman capsule

Giant cells

Giant cells

Karyorrhectic nuclear debris

Karyorrhectic nuclear debris


Necrotizing vasculitis

Necrotizing vasculitis

Fibrocellular crescent Fibrocellular crescent

Fibrocellular crescent

Fibrous crescent

Fibrous crescent

Electron microscopy images

Contributed by Anjali A. Satoskar, M.D.
Fibrin strands on ultrastructural examination

Fibrin strands on ultrastructural examination


Heavy chain deposition disease
Microscopic (histologic) images

Images hosted on other servers:

Various images


Hematopoietic stem cell transplantation associated thrombotic microangiopathy (HSCT-TMA)
Microscopic (histologic) images

Contributed by Dalia Y. Ibrahim, M.D., M.Sc.
Bloodless glomerulus

Bloodless glomerulus

Glomerulus with fibrin thrombi

Glomerulus with fibrin thrombi

Mucoid intimal thickening

Mucoid intimal thickening

Occluded artery with thrombus

Occluded artery with thrombus

Glomerulus with fibrin thrombi

Artery with thrombus and fragmented red blood cells

Glomerulus with fibrin thrombi

Occluded artery with thrombus, Trichrome stain

Electron microscopy images

Contributed by Dalia Y. Ibrahim, M.D., M.Sc.

Subendothelial widening, ultrastructural examination


Hemolytic uremic syndrome / thrombotic thrombocytopenic purpura
Diagrams / tables

Images hosted on other servers:
Etiologies of TMA

Etiologies of TMA

Diagnostic algorithm for TMA

Diagnostic algorithm for TMA

Microscopic (histologic) images

Contributed by Evelyn T. Bruner, M.D.
Prominent fibrin thrombi

Prominent fibrin thrombi

Glomerulus with prominent fibrin thrombi

Glomerulus with prominent fibrin thrombi

Glomerulus with endothelial swelling

Glomerulus with endothelial swelling

Glomerulus with prominent fibrin thrombi Glomerulus with prominent fibrin thrombi

Glomerulus with prominent fibrin thrombi


Artery with mucoid intimal thickening

Artery with mucoid intimal thickening

Glomerulus with prominent fibrin thrombi Glomeruli with prominent fibrin thrombi

Glomeruli with prominent fibrin thrombi

Peripheral smear images

Contributed by Dr. Avinash Mane (Case #403)
Numerous schistocytes and nucleated RBCs with extremely low platelets on peripheral smear Numerous schistocytes and nucleated RBCs with extremely low platelets on peripheral smear

Numerous schistocytes and nucleated RBCs with extremely low platelets on peripheral smear

Electron microscopy images

Contributed by Evelyn T. Bruner, M.D.
Endothelial swelling and lucency

Endothelial swelling and lucency


Henoch-Schonlein purpura (HSP)
Microscopic (histologic) images

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Missing Image

Various images


HIV associated renal disease
Diagrams / tables

Images hosted on other servers:

Mechanisms of HIV associated renal disease

Radiology images

Images hosted on other servers:

Ultrasound features of HIVAN

Microscopic (histologic) images

Contributed by Vincenzo L’Imperio, M.D. and Giorgio Cazzaniga, M.D.
Collapsed glomeruli Collapsed glomeruli Collapsed glomeruli

Collapsed glomeruli

Proliferative glomerulonephritis

Proliferative
glomerulonephritis

Tubular microcysts with sclerosed glomerulus

Tubular microcysts with sclerosed glomerulus

Tubular microcysts

Tubular microcysts

Electron microscopy images

Contributed by Vincenzo L’Imperio, M.D. and Giorgio Cazzaniga, M.D.
Tubuloreticular inclusion / aggregate (TRI) Tubuloreticular inclusion / aggregate (TRI) Tubuloreticular inclusion / aggregate (TRI)

Tubuloreticular inclusion / aggregate (TRI)

Mesangial deposits

Mesangial deposits

Subendothelial deposits

Subendothelial deposits


Hyperacute rejection
Gross images

Images hosted on other servers:
Missing Image

Cortex is blue, edematous and congested

Microscopic (histologic) images

Images hosted on other servers:
Missing Image

Various images


Idiopathic nodular glomerulosclerosis
Microscopic (histologic) images

Contributed by Saira Javeed, M.B.B.S., M.Phil. and Vincenzo L'Imperio, M.D.
Glomerular and tubulointerstitial damage

Glomerular and tubulointerstitial damage

Nodule formation Nodule formation

Nodule formation

Mesangial matrix expansion Mesangial matrix expansion

Mesangial matrix expansion


Mesangial matrix expansion

Mesangial matrix expansion

Lambda

Lambda

Kappa

Kappa

DNAJB9

DNAJB9

Electron microscopy images

Contributed by Vincenzo L'Imperio, M.D.
Glomeruli and tubules

Glomeruli and tubules

Glomerulus

Glomerulus


IgA nephropathy
Microscopic (histologic) images

Contributed by Maria Fernanda Soares, M.D., Ph.D.

M1 lesion, PAS

E1 lesion

S1p lesion, PAS


Crescent, PAS

Red cell casts

Acute arterial TMA

Mesangial IgA

CD68 and E1 lesion



Contributed by Arkana

Mesangial expansion and loop adhesion, Jones silver

Mesangial expansion and global sclerosis, PAS

Mesangial expansion and loop adhesion, PAS

Electron microscopy images

Contributed by Maria Fernanda Soares, M.D., Ph.D.

Mesangial deposits

Mesangial and paramesangial deposits


Contributed by Arkana

Mesangial deposits


IgG4 related disease
Radiology images

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Renal mass

PET positive mass

Gross images

Images hosted on other servers:

White renal mass

Microscopic (histologic) images

Contributed by Jonathan E. Zuckerman, M.D., Ph.D.

Tubulointerstitial effacement

Storiform fibrosis

Plasmacytic inflammation

Storiform fibrosis

Increased plasma cells


IgG plasma cells

IgG4 plasma cells

Plasma cells and eosinophils

Electron microscopy images

Contributed by Jonathan E. Zuckerman, M.D., Ph.D.

Tubular basement membrane deposits

Subepithelial deposits

Mesangial deposits

Bowman capsule deposits


Immunotactoid glomerulopathy
Microscopic (histologic) images

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Various images including EM

Electron microscopy images

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Figures e - h

With fibrillary glomerulonephritis


Indinavir nephropathy
Microscopic (histologic) images

Images hosted on other servers:

Biopsy findings

Crystal induced tubular injury

Indinavir crystals in urinary sediment

Electron microscopy images

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Granulomatous giant
cell reaction with
crystals within lumen


Infarct
Gross images

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Missing Image Missing Image

Wedge shaped hemorrhagic infarcts

Microscopic (histologic) images

Images hosted on other servers:
Missing Image Missing Image Missing Image

Various images


Light chain cast nephropathy
Diagrams / tables

Images hosted on other servers:
Pathophysiology of cast nephropathy

Pathophysiology of cast nephropathy

Microscopic (histologic) images

Contributed by Ramya Krishna Velagapudi, M.D., M.H.A.
Pale appearance of casts, PAS

Pale appearance of casts, PAS

Fractured appearance of casts, PAS

Fractured appearance of casts, PAS

Pale casts with giant cell reaction

Pale casts with giant cell reaction

Syncytial giant cell reaction

Syncytial giant cell reaction

Metachromatic casts, trichrome stain

Metachromatic casts, trichrome stain

Crystalline appearance of casts

Crystalline appearance of casts

Electron microscopy images

Contributed by Ramya Krishna Velagapudi, M.D., M.H.A.
Intratubular cast

Intratubular cast



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Intraluminal cast

Intraluminal cast

Granular cast

Granular cast

Crystalline appearance of casts

Crystalline appearance of casts

Videos

Washington University in St. Louis: renal pathology teaching series


Light chain deposition disease
Diagrams / tables

Images hosted on other servers:
Localization of MGRS associated renal lesions

Localization of MGRS associated renal lesions

Microscopic (histologic) images

Contributed by Ramya Krishna Velagapudi, M.D., M.H.A. and NephroPath
PAS positive mesangial expansion in a glomerulus Glomerulus with mesangial expansion - PAS

Glomerulus with mesangial expansion (PAS)

Mesangial expansion - Jones silver negative

Mesangial expansion (Jones silver negative)

Glomerulus - Jones silver stain

Glomerulus (Jones silver stain)

Light chain deposits along GBM

Light chain deposits along GBM

Trichrome stain

Trichrome stain

Electron microscopy images

Contributed by Ramya Krishna Velagapudi, M.D., M.H.A.
Powdery deposits along glomerular basement membranes Powdery deposits along glomerular basement membranes Powdery deposits along glomerular basement membranes

Powdery deposits along GBM

Powdery deposits along tubular basement membranes Powdery deposits along tubular basement membranes

Powdery deposits along TBM

Videos

Washington University in St. Louis Nephrology Web Series - multiple myeloma and the kidney


Light chain proximal tubulopathy
Diagrams / tables

Contributed by Rajib K. Gupta, M.D.

LCPT, crystalline variant

LCPT, noncrystalline variant

Microscopic (histologic) images

Contributed by Rajib K. Gupta, M.D., Ashley Flowers, M.D. and Judy King, M.D., Ph.D.

Acute tubular injury / necrosis in LCPT

Crystals within proximal tubular epithelium


Fuchsinophilic crystals within proximal tubular epithelium

Noncrystalline variant of LCPT

Electron microscopy images

Contributed by Rajib K. Gupta, M.D., Judy King, M.D., Ph.D., Ashley Flowers, M.D. and Xin Gu, M.D.

Intracytoplasmic crystals, crystalline variant of LCPT


Abnormal lysosomes, noncrystalline LCPT

Abnormal lysosomes with mottling, noncrystalline LCPT

Abnormal mitochondria, noncrystalline LCPT


Malakoplakia
Gross images

Images hosted on other servers:
Missing Image

Yellowish rubbery solid mass

Microscopic (histologic) images

Images hosted on other servers:
Missing Image

Michaelis-Gutmann bodies, high mag

Missing Image

Expansion of the interstitium

Missing Image

von Kossa stain

Missing Image

Infiltration of sheets

Missing Image

Histiocytes

Missing Image

CD68+

Electron microscopy images

Images hosted on other servers:
Missing Image

Tongue mass


Malignant hypertension and accelerated nephrosclerosis
Gross images

Images hosted on other servers:
Missing Image

Various images

Microscopic (histologic) images

Images hosted on other servers:
Missing Image Missing Image Missing Image

Various images


Medullary sponge kidney
Gross images

Images hosted on other servers:

Cysts of inner medullary and papillary region

Extensive cysts communicating with each other

Papillae are interspersed due to variably sized cysts

Small cysts with stones, papillae on right is not affected

Numerous medullary cysts and isolated cortical cyst

Cysts at corticomedullary junction

Microscopic (histologic) images

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Cysts in papilla

With microlithiasis and chronic pyelonephritis

Cortical cyst, multiple cysts
at the corticomedullary
junction and atypically
located papillary cyst


Membranous nephropathy
Microscopic (histologic) images

Contributed by Ana Belén Larqué, M.D., Ph.D.

Glomerular basement membrane thickened

Subepithelial spikes


Granular staining for IgG4

Granular staining for PLA2R

Electron microscopy images

Contributed by Ana Belén Larqué, M.D., Ph.D. and Jonathan E. Zuckerman, M.D., Ph.D.

Subepithelial deposits

Intramembranous deposits

Membranous nephropathy, stage I


Membranous nephropathy, stage II

Membranous nephropathy, stage III

Membranous nephropathy, stage IV



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Missing Image

Intramembranous deposits


Minimal change glomerulopathy
Diagrams / tables

Images hosted on other servers:
Missing Image

Lipoid nephrosis

Microscopic (histologic) images

Contributed by Ana Belén Larqué, M.D., Ph.D.
Normal glomerulus

Normal glomerulus

Normal glomerulus and interstitium

Normal glomerulus and interstitium

Tubules with hyaline droplets

Tubules with hyaline droplets

Aggregates of lipid laden macrophages

Electron microscopy images

Contributed by Ana Belén Larqué, M.D., Ph.D. and Nicole K. Andeen, M.D.
Foot process effacement

Foot process effacement

Hypertrophic podocytes

diffuse podocyte foot process effacement diffuse podocyte foot process effacement

Diffuse podocyte foot process effacement



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Missing Image

Foot process effacement


Monoclonal gammopathy of renal significance (MGRS) / paraprotein related kidney disease - general
Diagrams / tables

Images hosted on other servers:

Common MGRS nephron lesions

Microscopic (histologic) images

Contributed by Rajib K. Gupta, M.D., Ashley Flowers, M.D. and Lois J. Arend, M.D., Ph.D.
Nodular expansion of mesangium of glomerulus, AL amyloid Nodular expansion of mesangium of glomerulus, AL amyloid

Nodular expansion of mesangium, AL amyloid

Congo red under polarized light, AL amyloid

Congo red under polarized light, AL amyloid

Mesangial matrix expansion (nonnodular) of glomerulus, FGN Mesangial matrix expansion (nonnodular) of glomerulus, FGN

Mesangial matrix expansion (nonnodular), FGN

Membranoproliferative pattern of glomerulus in ITGN

Membrano-proliferative pattern, ITGN


Nodular mesangial matrix expansion, LCDD (MIDD) Nodular mesangial matrix expansion, LCDD (MIDD) Nodular mesangial matrix expansion, LCDD (MIDD)

Nodular mesangial matrix expansion, LCDD (MIDD)

Membranoproliferative pattern of glomerulus  in PGNMID

Membrano-proliferative pattern, PGNMID

Membranoproliferative pattern of glomerulus in C3G (C3GN)

Membrano-proliferative pattern, C3G (C3GN)

Membrano-proliferative pattern in type 1 CryoGN


Glomerulus in crystalglobulinemic GN

Crystalglobulin induced nephropathy

Mesangiolysis in a case of TMA with monoclonal gammopathy

Mesangiolysis in TMA with monoclonal gammopathy

Proximal tubules in LCPT, crystalline pattern

Proximal tubules in LCPT, crystalline pattern

Tubules in MIDD

Tubules in MIDD

Electron microscopy images

Contributed by Rajib K. Gupta, M.D., Ashley Flowers, M.D., Judy King, M.D., Ph.D. and Xin Gu, M.D.
Pale mesangial expansion due to amyloid fibrils

Pale mesangial expansion due to amyloid fibrils

Mesangial expansion by slightly thicker fibrils in FGN

Mesangial expansion by slightly thicker fibrils, FGN

Microtubular deposits in ITGN

Microtubular deposits, ITGN

Powdery deposits in LCDD / MIDD Powdery deposits in LCDD / MIDD

Powdery deposits, LCDD / MIDD


Glomerular deposits in C3-G (C3GN variant) Glomerular deposits in C3-G (C3GN variant)

Glomerular deposits, C3-G (C3GN variant)

Microtubular deposits in type 1 CryoGN Microtubular deposits in type 1 CryoGN

Microtubular deposits, type 1 CryoGN

Crystals in crystalline type LCPT

Crystals, crystalline type LCPT


Abnormal lysosomes in noncrystalline LCPT

Abnormal lysosomes, noncrystalline LCPT

Electron dense deposits in PGNMID

Electron dense deposits, PGNMID

Deposits in crystalglobulin induced nephropathy

Occlusive crystalline deposits, CIN


MPGN pattern of injury
Microscopic (histologic) images

Contributed by Haiyan Zhang, M.D., Ph.D.
GBM double contours

GBM double contours


Nephrocalcinosis
Microscopic (histologic) images

Images hosted on other servers:
Missing Image

Various images


Nephronophthisis
Gross images

Images hosted on other servers:

Cysts at corticomedullary
junction, tubular cysts
and interstitial infiltrate

Microscopic (histologic) images

Images hosted on other servers:

Tubules with thickened basal membrane (PAS)

Dilated tubules, thickened basal membrane (PAS)

Deformed tubules
with thickened basal
membrane in fibrotic
stroma (PAS)

Dilated tubules with lymphocytic infiltrate (PAS)



End stage renal disease:

Preserved glomeruli with individual glomerular cysts, tubulointerstitial fibrosis, hypertrophic tubules, lymphocytic infiltrate

Tubulointerstitial
fibrosis, tubular cysts
and lymphocytic
infiltrate (PAS)

Extensive obliteration of glomeruli
and sclerotic glomerli, interstitial
fibrosis, atrophic tubules and
chronic inflammation (PAS)

Electron microscopy images

Images hosted on other servers:

Tubules:

Thickened tubular basement membrane

Grid-like
degeneration of
tubular basement
membrane

Atrophic tubules
with partly thickened,
partly missing
basal lamina

Basal membrane shows
thickening, splitting,
grid-like degeneration
or complete absence


Collapsed glomeruli
centrally, Bowman
capsule is filled with
amorphous material

Partially atrophic tubule with thickened basal membrane

Newly formed lamellar basal membrane

Cyst wall lined
with collecting duct
epithelium, basal
membrane is lost



Glomeruli:

Thickened glomerular
basal membrane with
lacuna, periglomerular
fibrosis

Mild periglomerular fibrosis,
thickened tubules with
fragmented basal lamina,
lymphocytes


Obesity related glomerulopathy
Microscopic (histologic) images

Contributed by Jonathan E. Zuckerman, M.D., Ph.D.
Glomerulomegaly

Glomerulomegaly

Perihilar FSGS

Perihilar focal segmental glomerulosclerosis

Glomerulomegaly

Glomerulomegaly

Glomerulomegaly, tubular hypertrophy

Glomerulomegaly, tubular hypertrophy

Perihilar FSGS

Perihilar focal segmental glomerulosclerosis

Normal glomerulus

Electron microscopy images

Contributed by Jonathan E. Zuckerman, M.D., Ph.D.
Mild GBM thickening

Mild GBM thickening

Segmental foot process effacement

Segmental foot process effacement


Obstructive uropathy
Gross images

Images hosted on other servers:
Missing Image Missing Image Missing Image Missing Image

Various images


Oxalosis
Microscopic (histologic) images

Contributed by Jonathan E. Zuckerman, M.D., Ph.D.

Type 1 primary hyperoxaluria

Secondary oxalosis: calcium phosphate deposition


Secondary oxalosis: intraluminal calcium phosphate deposition

Fan shaped calcium oxalate deposits

Electron microscopy images

Contributed by Jonathan E. Zuckerman, M.D., Ph.D.

Oxalate crystals


Pauci-immune complex crescentic glomerulonephritis / ANCA associated vasculitis
Microscopic (histologic) images

Contributed by Ana Belén Larqué, M.D, Ph.D.
Missing Image Missing Image

Arterial wall with fibrinoid necrosis

Missing Image

Cellular crescent

Missing Image

Crescents

Missing Image

Segmental fibrinoid necrosis of glomerular tufts

Missing Image

Interstitial inflammation


Recurrent and de novo diseases
Diagrams / tables

Images hosted on other servers:

Rates of recurrence and graft loss risk

Prevalence, risk of allograft failure, clinical predictors

Prognostic and predictive biomarkers

Proposed management options

Characteristics and differences

Videos

Case #34 - HacettepePathology


Renal amyloidosis
Gross images

Images hosted on other servers:

Pale amyloid deposits in enlarged kidney

Microscopic (histologic) images

Contributed by Anthony Sisk, D.O.
Glomerulus

Glomerulus

PAS, glomerulus

PAS, glomerulus

Jones silver, glomerulus

Jones silver, glomerulus

Trichrome, glomerulus

Trichrome, glomerulus


PAS, tubulointerstitium

PAS, tubulointerstitium

Congo red

Congo red

Polarization of Congo red

Polarization of Congo red

Amyloid A stain

Amyloid A stain

Electron microscopy images

Contributed by Anthony Sisk, D.O.
Glomerular involvement

Glomerular involvement

Fibril measurements

Fibril measurements

Spicule formation

Spicule formation


Renal disease-general
Microscopic (histologic) images

Contributed by Saskia von Stillfried, M.D.
Normal glomerulus

Normal glomerulus

Thick appearance of GBM

Thick appearance of GBM

Mesangial hypercellularity

Mesangial hypercellularity

Membranoproliferative glomerulonephritis

Membrano-proliferative glomerulonephritis

Focal segmental glomerulosclerosis

Focal segmental
glomerulosclerosis

Nodular glomerulosclerosis

Nodular glomerulosclerosis


Global glomerulosclerosis

Global glomerulosclerosis

Cellular crescent

Cellular crescent

Normal tubuli

Normal tubuli

Acute tubular injury

Acute tubular injury

Interstitial fibrosis and tubular atrophy

Interstitial fibrosis and tubular atrophy

Interstitial inflammation

Interstitial inflammation


Rhabdomyolysis
Diagrams / tables

Images hosted on other servers:

Pathophysiology

Therapeutic
approaches

Microscopic (histologic) images

Contributed by Mazdak Khalighi, M.D. and Nicole K. Andeen, M.D.

Acute tubular injury with pigmented, granular and focally stringy appearing casts

PAS


Myoglobin


Sarcoidosis
Microscopic (histologic) images

Contributed by Alexei Mikhailov, M.D, Ph.D.
Sarcoidosis acute interstitial nephritis

Sarcoidosis acute interstitial nephritis

Granulomas in sarcoidosis

Granulomas in sarcoidosis

Granuloma involving an artery

Granuloma involving an artery

Interstitial nephritis between granulomas

Interstitial nephritis between granulomas

Multiple granulomas, Blau syndrome

Multiple granulomas, Blau syndrome

Large granuloma in Blau syndrome

Large granuloma in Blau syndrome


Scleroderma renal disease
Microscopic (histologic) images

Contributed by Christine M. Lee, M.D. and Jonathan E. Zuckerman, M.D., Ph.D.

Onion skin change

Onion skin change in artery

Mucoid intimal edema

Double contours

Electron microscopy images

Contributed by Christine M. Lee, M.D. and Jonathan E. Zuckerman, M.D., Ph.D.

Double contour

Artery remodeling


Sjögren syndrome
Microscopic (histologic) images

Contributed by Nicole K. Andeen, M.D.

Plasma cell rich tubulointerstitial nephritis (Jones stain)

Mesangial IgA deposition

Electron microscopy images

Contributed by Nicole K. Andeen, M.D.

Mononuclear inflammatory infiltrate


Spontaneous renal artery dissection
Gross images

Contributed by Jian-Hua Qiao, M.D.

Various images

Microscopic (histologic) images

Contributed by Jian-Hua Qiao, M.D.

Renal artery dissection

Renal cortex ischemic infarction


Renal papillae hemorrhagic infarction


Systemic lupus erythematosus
Diagrams / tables

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Ultrastructural features
of a single glomerular
capillary affected by
lupus nephritis

Gross images

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Diffuse proliferative lupus nephritis

Microscopic (histologic) images

Contributed by Alexei Mikhailov, M.D., Ph.D.

LN II: segmental mesangial hypercellularity

LN III: segmental fibrinoid necrosis

LN III: segment with karyorrhexis

LN IV: renal vasculitis

LN IV: endocapillary hypercellularity


LN IV: wire loops, hyaline thrombi

LN IV: vasculopathy

LN IV: torn capillaries

LN V: membranous alterations

LN V: microspikes

Electron microscopy images

Contributed by Alexei Mikhailov, M.D., Ph.D.

LN IV: immune deposits

LN IV: tubuloreticular inclusions

LN IV: organized deposits


Takayasu arteritis
Diagrams / tables

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Pathogenesis

Pathogenesis

Radiology images

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ECG gated double inversion recovery ECG gated double inversion recovery ECG gated double inversion recovery ECG gated double inversion recovery

ECG gated double inversion recovery


Fast gradient echo Fast gradient echo

Fast gradient echo

MR angiography MR angiography

MR angiography

Gross images

Contributed by Nicole K. Andeen, M.D.
White lesion

White lesion

Microscopic (histologic) images

Contributed by Nicole K. Andeen, M.D.
Active vasculitis with giant cells Active vasculitis with giant cells

Active vasculitis with giant cells

Tubulointerstitial inflammation Tubulointerstitial inflammation

Tubulointerstitial inflammation


Jones

Jones

Elastic Elastic

Elastic


Tamm-Horsfall protein
Diagrams / tables

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Diagram of Tamm-Horsfall protein secretion (green dots), forming a hyaline cast in the collecting duct

Microscopic (histologic) images

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Nephronophthisis: end stage renal disease

Lymphatics

Pyelonephritis - protein cylinder

Pyelonephritis immunostain

Electron microscopy images

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In lymphatics


Thin membrane disease
Microscopic (histologic) images

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Various images

Missing Image

Glomerulus shows
no abnormalities
on H&E

Tuberculosis
Radiology images

Images hosted on other servers:

Renal tuberculosis

Gross images

Case #128

Renal tuberculosis



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Renal tuberculosis

Microscopic (histologic) images

Case #128

Various images



Images hosted on other servers:

Various images

Miliary tuberculosis - kidney


Tubulointerstitial nephritis-general
Diagrams / tables

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Diagnosis of
inherited interstitial
kidney disease

Clinical images

Images hosted on other servers:

Drug induced tubulointerstitial nephritis

Microscopic (histologic) images

Contributed by Sam T. Albadri, M.B.Ch.B., M.Sc.

Interstitial inflammation

Tubulitis

Granulomatous interstitial nephritis

Eosinophilic tubulitis


IgG4 related kidney disease

IgG

IgG4 immunostain

Electron microscopy images

Contributed by Sam T. Albadri, M.B.Ch.B., M.Sc.

Interstitial inflammation and tubulitis

Videos

Histopathology kidney - interstitial nephritis


Urate nephropathy
Gross images

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Chronic urate nephropathy

Microscopic (histologic) images

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Gouty nephropathy


Urolithiasis (stones)
Diagrams / tables

Images hosted on other servers:

Passage of a calculus (stone)

Gross images

Contributed by Jian-Hua Qiao, M.D.
Multiple kidney stones

Multiple kidney stones


Xanthogranulomatous pyelonephritis
Radiology images

Contributed by Alexandra Barabasch, M.D.
Renal parenchyma on CT Renal parenchyma on CT

Renal parenchyma on CT

Dilated renal pelvis on CT Dilated renal pelvis on CT

Dilated renal pelvis on CT

Gross images

Contributed by Saskia von Stillfried, M.D.
Macroscopic appearance

Macroscopic appearance

Microscopic (histologic) images

Contributed by Saskia von Stillfried, M.D.
Zonal structure

Zonal structure

Middle zone

Middle zone

Xanthoma cells Xanthoma cells

Xanthoma cells

Touton giant cell

Touton giant cell

Cholesterol clefts

Cholesterol clefts


CD68+ macrophages (xanthoma cells) CD68+ macrophages (xanthoma cells)

CD68+ macrophages (xanthoma cells)

Pankeratin positive tubuli and negative macrophages

Pankeratin positive tubuli and negative macrophages

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Recent Kidney nontumor / medical renal Pathology books

Chang: 2018

D'Agati: 2005

Fatima: 2019

Husain: 2021

Jennette: 2023

Jiang: 2023

Satoskar: 2017

Yu: 2019

Zhou: 2017



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