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The painting above of a kidney transplant biopsy shows mild interstitial inflammation and tubulitis. If this field is representative, these changes would be consistent with borderline changes suspicious for T cell-mediated rejection (TCMR). A diagnosis for borderline changes suspicious for TCMR can be made with mild interstitial inflammation (i1; 10-25% of cortex) with any degree of tubulitis (i1t1 with 0-4 lymphocytes/tubular profile, i1t2 with 4-10 lymphocytes per tubular profile, i1t3 with >10 lymphocytes per tubular profile or tubular basement membrane rupture), by moderate interstitial inflammation (25-50% of cortex) with mild tubulitis (i2t1), or with isolated tubulitis without interstitial...