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Currently filtering by tag: Banff

Twitter Poll (July 22, 2020)

Polyomavirus Nephropathy, Banff Class 3, Twitter Poll, Arkana Laboratories
ANSWER: C The answer is C, Polyomavirus Nephropathy, Banff Class 3. The Banff Working Group Classification was created by Nickeleit et al. to provide a classification scheme to aid communication, better standardize reporting of polyomavirus nephropathy, and provide a way for better comparative analysis of cases going forward. The classification is broken into three classes, Banff Class 1-3. This case highlights an example of a Polyomavirus Nephropathy, Banff Class 3 with a pvl score of 3 and ci (fibrosis) score of 2. Based on this score, the findings of the Banff working group showed that approximately 50% of these patients...

Twitter Poll (March 25, 2020)

twitter poll results, twitter analysis, quiz, arkana laboratories
  ANSWER: True In 2018, Nickeleit et al. postulated a morphologic classification of polyomavirus nephropathy (PVN) based on pathologic features that correlate with clinical outcomes. The study defines 3 morphologic PVN classes using interstitial fibrosis and intra-renal PV load levels as statistically verified class denominators. It describes class 1 as an early PVN stage with favorable outcome, and classes 2 and 3 as having more pronounced impact on function with graft failure rates reaching 50% in class 3. The proposed PVN classification aims at improving clinico-pathologic correlation and the comparability of studies: a simple biopsy diagnosis of "PVN" no longer...

Twitter Poll (June 26, 2019)

TCMR, arkana laboratories, renal pathology, kidney biopsy
ANSWER: C Severe intimal arteritis (v2), with or without interstitial inflammation and/or tubulitis is considered acute TCMR Grade IIB based on the Banff 2017 classification. However, we now know that arterial lesions (v>0) may be indicative of ABMR, TCMR or mixed ABMR/TCMR and are not restricted to TCMR. Reference: Haas M, et al. The Banff 2017 Kidney Meeting Report: Revised diagnostic criteria for chronic active T-cell mediated rejection, antibody-mediated rejection, and prospects for integrative endpoints for next-generation clinical trials. Am J Transplant. 2018; 1-15.    

Diagnose This (June 17, 2019)

Lymphocytic Tubulitis & Inflamation, allograft, renal pathology, Diagnose This!, Arkana Laboratories
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?       ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​...

Art of Medicine: Borderline Changes for TCMR Painting

Borderline Changes for TCMR
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...