Case 17: Pathology

Case 17 Index

Excellent work, your patient tolerated the kidney biopsy well. It’s the morning afterwards and your pathologist shows you this H&E stain.  Click here for some quick pathology tips.


Which one of the following do you see below?
Crescent formation
Excellent! We see extracapillary proliferation with obliteration of Bowman’s space. Crescents can be characterized as cellular (active disease), fibrous (chronic disease), or fibrocellular crescents. Here, we see a mainly cellular crescent without significant fibrous material, though this material would be best visualized with a Periodic-Acid Schiff  or PAS stain. Take a look at another crescent (PAS stain) below:  
Inflammatory infiltrate in the interstitial space
Though this is not the best view of the interstitum, the small parts that we do see do not seem to have inflammatory cell infiiltration.
Podocyte effacement
The podocyte structure is best visualized under electron microscopy, not light microscopy.
Subepithelial deposits
Subepithelial deposits are best seen under electron microscopy, not light microscopy.

Click here once you’re ready to look at more stains (your pathologist explains it will take 1-2 days…) to further help you narrow your differential diagnosis!

Case 17 Index
Case 17 Introduction
Case 17 Physical Exam

Case 17 Diagnostic Testing