Renal Path Labs

This FSGS was scarier than any crescent…fierce looking, activated podocytes as if ready to engulf the tuft.. And look at the tuft-scared to the core.. 🥹😱 #CollapsingFsgs #RenalPath #PathTwitter #Nephtwitter #RenalPathSociety #AskRenal #RenalPathLabsGurugram #KidneyBiopsy

We dream big, but keep our feet on ground… #RenalPathLabs #RenalPathology #KidneyBiopsy #OnlineLearning #Nephtwitter #OnlineRenalPathology

📌 Renal Pathology Pearl : ✅Light Chain-Only PGNMID🔦 Light chain–only PGNMID (PMID: 32001067 ) shows monotypic light chain deposits (κ or λ) with absent heavy chains , a true light chain–only pattern. 💡 Key features: • IF: Isolated light chain restriction ± C3 co-staining (reflects alternative pathway activation, not primary C3 glomerulopathy). • LM: MPGN, endocapillary proliferative, or mesangial proliferative patterns. • EM: Granular, electron-dense deposits (non-organized). • Always evaluate for underlying B-cell/plasma cell clone. 📍 C3 positivity is common and due to complement activation, but not C3G — diagnosis rests on true monoclonal light chain restriction. @Renalpathsoc @MCFNephFellows @MayoClinicNeph @MayoClinicPath

🧠🩺 Renal Pathology Pearl: Lysozyme (Lysosomal) Nephropathy 📌 Often seen in CMML / monocytic leukemias
📌 Causes tubular (non-albumin) proteinuria 🔬 Light Microscopy
• Predominant tubulointerstitial injury
• Proximal tubules with eosinophilic, granular/vacuolated cytoplasm
• Interstitial inflammation ± fibrosis
• Glomeruli largely unremarkable 🧪 Immunofluorescence
• Negative for IgG, IgA, IgM
• Negative kappa/lambda
• C3 absent or nonspecific
• (If performed: strong cytoplasmic lysozyme staining in proximal tubules) 🔍 Electron Microscopy
• Proximal tubular cells packed with enlarged lysosomes
• Lysosomes contain electron-dense granular ± crystalline material
• No immune-type deposits in glomeruli or TBMs 🧩 Key clue: High UPCR + low ACR → non-albumin proteinuria
🚫 Argues against AL amyloid, LCDD, PGNMID #RenalPath #NephPath #LysozymeNephropathy #KidneyBiopsy #MedEd @MayoClinicPath

New batch for online Renal Pathology Classes starting soon!!! Register now! #RenalPathLabs #nephtwitter #RenalPathology #NephrologyResidents #PathTwitter #Nephpath

RIMS on AIIMS lines is great, but at what cost? RUHS employees’ jobs & 150 govt MBBS seats hang in balance. Build new, don’t destroy old! Join the fight. #BuildRIMSSaveRUHS #ProtectRUHSEmployees @rajasthan @NMC_IND

@sijiezheng @ChangUCanSpare Great catch of words and IgA..That will be the most funny thing of Renal Pathology so far..

@ChangUCanSpare Maybe IgA is a “Pattern of injury “? Just like FSGS, MPGN

IgA nephropathy is defined by dominant or co-dominant IgA deposition but this rule was created before the existence of C3G. We need to re-think this definition

The light microscopic image depicts interstitial foam cells which, while non-specific and can be seen in longstanding proteinuria, are concerning for Alport Syndrome given the clinical scenario of hematuria and hearing loss. By electron microscopy, diagnostic findings would include glomerular basement membrane splitting, scalloping, multilamellation or "basket-weaving", intramembranous "bread crumbs", and abrupt transitions from areas of thin and thick GBMs. An Alport staining panel will classically show loss of staining for collagen IV alpha 5 in the majority of cases (~85%, X-linked inheritance). #renalpath #kidneypath #pathology #renal #pathX

Classic example of Alport spectrum disease in a pt with X-linked Alport syndrome. Lesions of segmental glomerulosclerosis, numerous interstitial foam cells, and atypical GBMs with lamina densa splitting, subepithelial scalloping, and thinning. #renalpath #pathtwitter #nephrology

Isometric vacuolization of tubular epithelial cells (foamy tubular cells) in a case of Acute CNI toxicity #renalpathology #CNItoxicity #isometricvacuolization @draalok @RitambhraN @vinaypush @JZRenalPath @Renalpathsoc

Nice example of striped fibrosis which is often attributed to chronic CNI toxicity in kidney transplant biopsies. #renalpath #pathtwitter

@BajinderR @sijiezheng Indian!

@RenalPathLabs @sijiezheng What nationality patient is?

This FSGS was scarier than any crescent…fierce looking, activated podocytes as if ready to engulf the tuft.. And look at the tuft-scared to the core.. 🥹😱 #CollapsingFsgs #RenalPath #PathTwitter #Nephtwitter #RenalPathSociety #AskRenal #RenalPathLabsGurugram #KidneyBiopsy

@sijiezheng Yet to find out. Not HIV.

@RenalPathLabs Etiology?

Potpourri of Post Tx infections!! CMV, BKV, Mucor &Candida!! Add images of infections you come across, in comments!! #RenalBiopsy #NephTwitter #PathTwitter #RenalPathSociety #AskRenal #ISRTP #RenalPathLabsGurugram #PostTxInfections #PoojaMaheshwari

Random reminder: hematuria in thin basement membrane nephropathy. Is this how it occurs? #renalpath

Electron microscopy examination of the Kappa light chain cast nephropathy reveals atypical casts characterized by granular, electron-dense material and fibrillar texture deposits #renalpath

Sad to see the slow erasure of Hindus & their heritage. Numbers don’t lie. Brief check of the census data shows that from ~30% they are now down to less than 8% (ground reality could be worse)

@docrobin52 @Renalpathsoc You are right.. It’s necrotising granulomatous vasculitis..

@RenalPathLabs @Renalpathsoc Don’t see kidney biopsy, but I’ll try. Silver stain showing vasculitis of a medium sized artery, granular casts and dense interstitial inflammation. 🤔

Images say it all. The disease,the process,possible culprit, the misery of that organ system & about the nicely done stain..Residents,want to describe this pic?Native Bx #PathoResidents #NephrologyResidents #PathTwitter #Nephtwitter #AskRenal #RenalPathLabsGurugram @Renalpathsoc

Interactive, informative & fun.. That defines our online Renal Path Classes for Nephro & Pathology residents for Indian& overseas students..More info & link on our LinkedIn platform.Let’s learn together.. #RenalPathClasses #UroNephModules #RenalPathLabs #Nephtwitter #PathTwitter