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Normal glomerulus with capillary tubule & mesangial cells in between. (H&E stain)

لا يجوز ان يكون اكثر من ٣ خلايا mesangial بجانب بعض بالوضع الطبيعي.

في حالة وجود اكثر من ٣ خلايا mesangial بجانب بعض تصبح اسم الحالةMesangial hypercellularity

PAS stain (Periodic acid–Schiff) —-> تغمق collagen & Basement membrane

Note —> mason trichrome stain fibrosis in blue colour.

Electron micrography (Normal pic)

Podocyte foot processes

Fenestrated endothelium

Effacement of foot processes in MCD (Minimal change disease)

Electron dense RBC

BM

Fenestrated endothelium

Obliterated capillary, Segmental (part of glomerulus) sclerosis (fibrosis)

Same as previous slide but different stain (Mason trichrome stain)

Hypercellular (Proliferative) glomerulus

Small cells are neutrophils with segmented nucleus (inside glomerulus)Lobulated structure (closed lobes)

We think of poststreptococcal/postinfectious GNOr Memranoproliferative GN

Same as previous slide but on high magnificationNotice neutrophils in here clearly

Subepithelial humps (btw BM & podocyte)Post streptococcal GN feature

Capillary lumen

Immunoflorescence (capillary granular)In many diseases such as membranous nephropathy

H&E stain, thickening in capillary lobes (BM) Diffused

Silver stain, BM appear in black

Spikes appear here in black (على شكل شعيرات صغيرة) in membranous nephropathy

Note —-> Amyloid appear in Congo Red stain

Capillary granular in IF

Capillary granular in IF

PAS stain (fusci color fibrosis on BM & around tubules)

Crescent proliferation in urinary space (parietal cells)

Wire loops (حلقة غير مكتملة ذات جدار سميك) mainly in active lupus nephritis class III & IV

Tubule

H&E stain (bad stain)Crescent proliferation may convert to fibrosis (Pauci-immune)

Capillary Linear in If

Goodpasture syndrome (only appear as linear)

Mesangial hypercellularity (اكثر من ٣ خلايا بجانب بعض)In IgA nephropathy

Mesangial granular in IfMesangial always granularتكتلات عشوائية

Same as previous slide

Glomerulus with a lot of cells (closed)no neutrophils (so no postinfectious/post streptococcal GN)Maybe membranoproliferative GN

Silver stain, Tram-truck appearance (double circular line)In membranoproliferative GN