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Diagnose This (August 24, 2021)

Amyloidosis, AA amyloid, IV drug, proteinuria
This is the biopsy of a 32yo IV drug user who has nephrotic range proteinuria and MSSA bacteremia secondary to a skin abscess. What is this stain and what is your diagnosis?     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​  ...

Diagnose This (August 2, 2021)

Amyloid Proximal Tubulopathy
This biopsy is from a 61yo male with DM, CHF, CKD4, and an abnormal SPEP. UMOD IHC was negative. What is your diagnosis?     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​...

Diagnose This (June 14, 2021)

sickled cell within a glomerular capillary
What would be your diagnosis for these findings in a 30-year-old African American male with CKD stage III and proteinuria?     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​...

Diagnose This (May 31, 2021)

intravascular large B-cell lymphoma (LBCL) in renal biopsy at Arkana Laboratories
This is a CD20 immunohistochemical stain. Knowing that these cells are mostly within peritubular capillaries, what is your diagnosis?     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​...

Diagnose This (May 25, 2021)

hronic active antibody-mediated rejection biopsy at arkana laboratories
In an allograft biopsy, what would be your diagnosis for this combination of findings?     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​   ​...

Diagnose This (May 10, 2021)

juxtaglomerular apparatus hyperplasia in renal biopsy at Arkana Laboratories
What is your diagnosis for this finding in a young patient with renal artery stenosis?     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​  ...

Diagnose This (May 3, 2021)

Serum Amyloid Protein (SAP) from renal biopsy at Arkana Laboratories
This image is from a biopsy of a young female who presented with proteinuria during pregnancy. Routine immunofluorescence was negative. What is this stain and what is your diagnosis?     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​...

Diagnose This (April 5, 2021)

ACNA or Anti-GBM
In a patient with these findings, which serological exams results would you be interested to know?     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​ ​   ​ ​   ​ ​...

Chronic Cyclosporine Toxicity in Pediatric Nephrotic Syndrome

Pediatric Nephrotic Syndrome, childhood nephrotic syndrome, CSA, CNI, juxtaglomerular apparatus
This biopsy is from a 9-year-old boy who developed pediatric nephrotic syndrome in the first year of life and has been maintained on cyclosporine (CSA) due to frequent relapses. He had not had a biopsy before and was clinically on remission, considering switching to rituximab. The biopsy was performed to assess chronic changes and the presence of histologic signs of chronic calcineurin inhibitor (CNI) toxicity CNI toxicity. His serum creatinine was 0.6 mg/dL. He was also on lisinopril for proteinuria control. He was not hypertensive. The biopsy contained a total of 61 glomeruli, four of which were globally sclerotic. No...