PMC10237351_01
Kidney bioptic specimen showing diffuse lymphomonocytic inflammatory infiltrates ( ) associated with intertistial fibrosis, widespread findings of tubular atrophy ( ) and vascular wall thickening (*) [H&E staining, top images, 100x magnification left (A) and 200x magnification right (B)]; PAS staining [bottom images, 100x magnification left (C) and 200x magnification right (D)] furtherly illustrating glomerular sclerosis (o), glomerular capsule and basement membranes thickening (*), plus a number of intratubular hyaline casts ( ) deeper into the medullary part of nephrons (the so-called tubular <<thyroidisation>> phenomenon).
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At microscopic analysis, a tubular atrophy emerged with interstitial fibrosis, lymphomonocytes infiltrates and vascular hyalinosis, all suggestive of DKD ( Figure 1 ).