The image shown comes from a kidney transplant patient with a rise in serum creatinine. What is the most likely diagnosis and what immunohistochemical stain would you want to rule out a less common disease sometimes seen in kidney transplants?
The image shows lymphocytic tubulitis and surrounding lymphocytic inflammation. These findings are most commonly seen in acute T-cell mediated rejection (Banff IA or IB). However, BK/Polyoma virus nephritis can show similar findings and viral cytopathic atypia may not be present making an SV40 immunohistochemical stain useful in excluding this etiology.
Quick note: This post is to be used for informational purposes only and does not constitute medical or health advice. Each person should consult their own doctor with respect to matters referenced. Arkana Laboratories assumes no liability for actions taken in reliance upon the information contained herein.