PMC8666564_01
Histological findings on renal biopsy. (A) Light microscopy study of the renal biopsy specimen revealed segmental endocapillary proliferation with neutrophil infiltration. (PAS, x400). (B) The tubules displayed acute injury with epithelial simplification and small focal atrophy (Masson trichrome staining, x200). (C) Renal interstitial was infiltrated by focal lymphocytes (x100). (D) Immunofluorescence analysis revealed positive granular staining of IgG in the mesangium and capillary wall. (E) Electron microscopy showing electron-dense deposits in the sub-epithelial and segmental mesangial. (F) Interstitial infiltration of a nodular mass of medium-sized lymphoid cells with irregular nuclei. (PAS, x400). (G-I) Immunohistochemical analysis revealed lymphoblasts were strongly positive for CD 20 (G), CD5 (H), and Cyclin D1 (I) (Panels were indicated from left to right with letters A-I).
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F1
Severe foot process effacement was also discovered (Figure 1).
The clinical course of the present case. R2 Therapy indicates Rituximab and lenalidomide.
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F2
The patient's ANA was 1:100, anti-dsDNA levels negative, and C3 and C4 immediately returned to normal level after just one round of chemotherapy (Figure 2).