PMC4998279_01
Computed tomography reveals left hydronephrosis (arrow).
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F1
In November 2014, he presented to the urologist with left severe hydronephrosis associated with marked thickness of the left ureter wall and retroperitoneal fibrosis discovered by a computed tomography scan (Figures 1 and 2).
Contrast-enhanced arterial phase computed tomography image shows soft-tissue mass surrounding aorta (arrow), indicating retroperitoneal fibrosis.
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F2
In November 2014, he presented to the urologist with left severe hydronephrosis associated with marked thickness of the left ureter wall and retroperitoneal fibrosis discovered by a computed tomography scan (Figures 1 and 2).
Immunohistochemistry of the inflammatory cells in renal cortex shows IgG-positive plasma cells, with 50% to 60% of these cells also being positive for IgG4 (brown) (x400).
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F3
More than 50% of plasma cells positive for IgG were positive for IgG4 (Figure 3).
Granular electron-dense deposits (arrow) are accumulated in the thickened tubular basement membrane. TC = tubular cell, PC = plasma cell (x100).
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F4
By electron microscopy, electron-dense deposits were seen in tubular basement membrane (Figure 4).
IgG immunofluorescence reveal strong accumulation in the tubular basement membrane and Bowman capsule. Interstitial deposits are also observed.
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F5
Bowman capsule (Figure 5). Based on pathologic results after surgery, we analyzed stored preoperative serum retrospectively.