PMC4360725_01
a Rarefaction of tubules and glomeruli, severe interstitial inflammatory infiltrates and fibrosis (arrow), PAS x10. b Interstitial nephritis with dense lymphoplasmacytic infiltrations and eosinophils (arrows), PAS x400. c The majority of interstitial inflammatory infiltrates were IgG-producing plasma cells (arrows). Immunohistochemistry for IgG, x400. d The majority (>40%) of IgG+ plasma cells appear positive for IgG4 (arrows). In absolute numbers, >50 IgG4+ plasma cells are seen per hpf. Immunohistochemistry for IgG4, x400. e Focal thickening of GBMs with C4d positivity indicating MN lesions. Immunohistochemistry for C4d, x200. f Electron microscopy revealed the presence of subepithelial (arrows) and scarce mesangial deposits compatible with secondary MN, x15.000.
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F1
CD3+ and CD20+ lymphocytes and eosinophils (fig. 1). Congo red stain was negative.