Case 28: Pathology

Case 28 Index

Excellent work, your patient tolerated the kidney biopsy well. Let’s take a look at the stain below.  Click here for some quick pathology tips.

2

First things first. What type of stain is this?
Hematoxylin & Eosin (H&E) stain
In the stain above, we see a deep pinkish/magenta staining of collagen and the tubular basement membrane. We would not see that with and H&E stain. Try again!
Periodic Acid-Schiff (PAS) stain
Correct! The PAS stain allows us to visualize collagen structures better by staining it a deep pink/magenta color as seen here.
Silver stain
Though the silver stain does stain for collagen, we would see this as a black color rather than a pink/magenta. Try again!
Immunohistochemistry (IHC) stain
IHC stains look for a specific antigen and stains this antigen a brown color. We don’t see that here.
Masson’s trichrome stain
The trichrome stain is used to look for fibrosis – which typically stains a bright blue color. Try again!

The pathologist points out several areas of amorphous pale-staining material on the stain (see below).

28 answer

 

What is highest on your differential diagnosis? Choose 3 before moving on.
Myeloma cast nephropathy
Systemic lupus erythematosus (SLE) nephritis
Light chain deposition disease
Amyloidosis
Post-infectious glomerulonephritis
Membranoproliferative glomerulonephritis
IgA nephropathy
Acute interstitial nephritis
Obstructive uropathy
Hypertensive nephropathy
Light chain proximal tubulopathy
Heavy chain deposition disease
Focal segmental glomerulosclerosis (FSGS)

Click here to view additional pathology!

Case 28 Index
Case 28 Introduction
Case 28 Physical Exam
Case 28 Diagnostic Testing