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This biopsy came to us for evaluation of nephrotic syndrome. The patient is a Hispanic gentleman in his late 80s, with CKD stage IV and a history of arthritis, diabetes mellitus, coronary artery disease, and hypertension. He had 4.9 g/g of proteinuria. He had negative ANA, hepatitis B, and C serologies. C3 and C4 were within normal limits. Clinically, the differential diagnosis included membranous glomerulopathy and FSGS. The biopsy was a very good sample, consisting of long cores of renal tissue, mostly from cortex. More than 20 glomeruli were present. The glomeruli had clear features of diabetic nephropathy, as expected...