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Increase in cells over normal; response to immune mediated injury
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Proliferation
Increase in cells over normal; response to immune mediated injury
Proliferation is a response to what type of injury?
Immune mediated
Endothelial proliferation generally occurs following what type of kidney disease?
Acute post-infectious glomerulonephritis
Mesangial proliferation
>4 cells/mesangial zone
Mesangial proliferation expands mesangial zone at expense of what?
Capillary area
Mesagnial proliferation generally occurs in what type of kidney disease?
Berger's IgA nephritis, lupus, Henoch-Scholein purpura, membranoproliferative glomerulonephritis
Epithelial proliferation
Increase in parietal epithelial cells--> commpresses glomerular tuft
What is the effect of epithelial proliferation on the glomerular tuft and capillaries?
Compresses glomerular tuft, causes collapse of capillaries
What is epithelial proliferation also called?
Crescent proliferation
Necrosis is a feature of what type of injury?
Intense inflammatory injury
What is fibrinoid necrosis?
Fibrin deposits with karyorrhectic debris
In what kind of proliferation is fibrinoid necrosis typically seen?
Epithelial proliferation
In what kinds of kidney disease is epithelial proliferation typically seen?
anti-GBM nephritis, lupus, Wegener's granulomatosis
What are the characteristics of the "other" kind of necrosis?
cell injury characterized by only karyorrhexis without fibrin
What is the definition of sclerosis?
Absolute or relative increase in either mesangial matrix or basal lamina
Is sclerosis PAS+? Why?
PAS+ because of glycoproteins present in the collagen
What are the characteristics of hyalinosis?
Acellular glossy material, contents include serum proteins, lipids, and glycoproteins
How does hyalinosis stain with H and E? With PAS?
Red with H and E, magenta with PAS
In what kidney diseases is hyalinosis seen?
DM, many proliferative diseases in association with sclerosis
Where in the kidney is hyalinosis seen?
In nonfunctional glomerular segments
To what does "deposits" refer?
Presence of immune complexes
Where are subepithelial deposits found?
Between glomerular BM and epitherlial cells
Where are intramembranous deposits found?
within GBM
Where are subendothelial deposits found?
Between GBM and endothelial cell
Where are mesangial deposits found?
within the mesangium
What is a linear deposit?
Continuous, uninterrupted deposits of Ig and complement along the capillary wall
What is a granular deposit?
Interrupted discontinuous deposits of Ig and complement along the capillary wall or in the mesangium
Diffuse glomerular injury
More than half of the glomeruli
How does a patient with diffuse glomerular injury present?
Fluid retention and decreased renal function
Focal glomerular injury
Abnormality that involves less than half of the glomeruli
How does a patient with focal glomerular injury present?
May have hematuria or proteinuria, but usually has normal or only mild reduction in renal function
Global glomerular injury
Refers to all parts of an individual glomerulus
Segmental glomerular injury
Refers to part of an individual glomerulus
What are three reasons for glomerular capillary wall thickening?
1.) increase in glomerular BM; 2.) subepithlial, subendothelial, intramembranous immune complex deposits; 3.) mesangial interposition--> growth or extension of mesangial cells between the peripheral capillary wall BM and the endothelial cell that is normally attached to the BM
Definition of "crescent"
Lesion consisting of proliferating epithelial and inflammatory cells--> fills in part of all or Bowman's space; minimum requirement is presence of at least 2 layers of cellular proliferation
Filtration slit diaphragm
Thin membrane that bridges adjacent foot processes--> congenital absence associated with mutation sin NPHS1 gene, "nephrin,"
"Hump-like deposit"
Large, usually isolated subepithelial deposits characteristic of post-infectious glomerulonephritis
Kimmelstiel-Wilson nodules
Nodular aggregates of mesangial matrix and cells in diabetic glomerulosclerosis
Lipoid nephrosis
Another term for "minimal change nephrotic syndrome"
Nil lesion
Another term for "minimal change nephrotic syndrome"
Definition of "spike"
Extension from GBM of BM-like material between subepithelial deposits
Definition of "tram-tracking"
Double contoured appearance to the glomerular capillary wall
What is tram-tracking characteristic of?
Membranoproliferative glomerulonephritis--> due to extension of mesangial cells between endothelial cell and GBM
Visceral epithelial cell
Podocyte (Epithelial cell on the external surface of the GBM)
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