PMC9340899_01
(A) Jones Silver Stain at 40x magnification: central glomerulus showing collapse of the glomerular tuft with overlying podocyte hypertrophy, proliferation, and cytoplasmic protein reabsorption droplets. (B) H and E at 2x magnification: low power image of 2 biopsy cores showing multiple granulomas. (C) CD163 immunohistochemical stain (histiocytic marker) showing increased staining of histiocytic cells in the areas of granulomatous inflammation, indicated by the circles. (D) Electron microscopy image at 25 000x magnification: tubuloreticular inclusion in the endothelial cell cytoplasm (center). (E) Electron microscopy at 4000x magnification: diffuse effacement of the podocyte foot processes. (F) H and E at 40x magnification: high power image of 2 granulomas indenting either side of a dilated distal tubule showing a mitotic figure in an epithelial cell. The granuloma on the left shows prominent multinucleated cells and the one on the right shows mixed inflammatory cells. Intense background interstitial inflammation with scattered eosinophils is seen away from the granulomata.. Abbreviation: H and E, hematoxylin and eosin.
10.1177_23247096221114517-fig1.jpg
PMC9340899_01_10.1177_23247096221114517-fig1.jpg
fig1-23247096221114517
The endothelial areas were remarkable for multiple tubuloreticular inclusions within the endothelial cell cytoplasm (see Figure 1).