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Nucleated Red Blood Cells in Circulation

Nucleated Red Blood, teaching point, arkana laboratories
The patient is a 70-year-old male who presents with a creatinine of 5 mg/dl and a history of primary myelofibrosis. The biopsy shows a kidney with severe glomerular and tubulointerstitial chronicity, approaching end-stage kidney disease from arterionephrosclerosis. Interestingly, circulating nucleated red blood cells were identified in the arteries and peritubular capillaries. Although not representing a specific kidney disease, the presence of nucleated red blood cells within the circulation points toward premature release of erythroid precursors from the bone marrow. This finding is has been reported in the setting of a space-occupying lesion in the bone marrow from metastases or in...

A tale of two cores…

A Tale of Two Cores, cores, arkana laboratories, renal pathology
Core “A” and “B” were taken from the same patient during the same biopsy procedure. The red blood cells within the tubules in core “B” represent a biopsy artifact sometimes seen when multiple passes are made during the same biopsy procedure. One confirmatory clue is the presence of red blood cells surrounding the periphery of core “B” – these are not present in core “A” which was likely the first core taken during the biopsy.