Heavy Chains, Heavy Consequences: A Case of Concomitant Heavy Chain Amyloidosis and Heavy Chain Deposition Disease. Fibrils and powdery deposits. #renalpath #nephsky #pathsky www.sciencedirect.com/science/arti...

🔬 We are now recruiting a Renal Pathologist! #pathology #path2path #PathSky #renalpath Join our team today! ➨ bit.ly/46CqsrU

Multiple diagnoses not uncommon in kidney biopsies. This case showed nodular diabetic nephropathy, a mostly chronic ANCA associated GN, and to top it off some interstitial ALECT2 amyloidosis. #renalpath #nephsky #pathsky

Lupus nephritis case with prominent podocyte cytoplasmic vacuolization on LM with myelin figures revealed by EM. Probably HCQ effect but given its prominence genetic etiologies should be excluded (e.g., Fabry, LMX1B). #renalpath #pathsky #nephsky

Interesting case of AL-amyloidosis. Massive vascular deposits, even in hilar arterioles with glomerular sparring. Patient had minimal proteinuria given lack of glomerular amyloid. #renalpath #pathsky #nephsky

Nice example of urate crystals in gouty tophi involving the medulla. Polarizable crystals can be see using unstained sections from the IF tissue. #renalpath #pathsky #nephsky

Another example of an 'incidental' finding next to the tumor in a nephrectomy specimen. Amyloidosis (probably LECT2). Reminder not too overlook the non-neoplastic tissue. #renalpath #pathsky #nephsky

ANCA GN Working Group Meeting More info for EUVAS Florence Working Group - Symposium on ANCA GN Classification-Scoring Systems, click link 👉https://vasculitis.org/ Register: app.donorfy.com/form/ZU81NH9... @brixsilke.bsky.social & Ingeborg Bajema #renalpath #vasculitis #pathsky #nephsky

Multi-focal severe necrotizing arteritis in a kidney biopsy with an ANCA vasculitis. Interestingly, foci of arteritis were only present in IF/EM tissue. Illustrating how even when severe arteritis can be easily missed due to sampling in a small biopsy. #renalpath #nephsky #pathsky

Great work by our chief resident @clilleymd.bsky.social on charactering microscopic tubulo-venous communications in kidney biopsies. www.kidneymedicinejournal.org/article/S259... . Here's another nice example (x.com/JZRenalPath/...) #renalpath #pathsky #nephsky

Kidney txp biopsy with histologic features of acute pyelonephritis. Neutrophilic tubulitis, neutrophilic casts, and tubules which seem to explode out. Cellular rejection typically is not neutrophilic and inflammation hits the tubules from the outside in. #renalpath #nephsky #pathsky

The August issue of CJASN is now available online! Topics covered this month include: - GLP-1 receptor antagonists in patients receiving dialysis - Transportation access and dialysis outcomes - and more Check out the issue here: journals.lww.com/cja... #ASNCJASN Cover by @JZRenalpath et al.

🔬 We are now recruiting a Renal Pathologist! #pathology #path2path #PathSky #renalpath Join our team today! ➨ bit.ly/4ll8K09

Wide variety of morphologies in this case of crystalline light chain proximal tubulopathy: mottle lysosomes, crystals, and fibrils. #renalpath #nephsky #pathsky

One of the more subtle amyloid cases I have seen. Just a few deposits in 2 gloms by LM. Just enough congo red staining. Glad to catch it in the EM as well. #renalpath #nephsky #pathsky

Some well formed "eye lashes" on these capillary loops in a case of AL-amyloidosis. Podocytes getting skewered by the spicules in the EM. #renalpath #pathsky #nephsky.

Classic example of Alport spectrum disease in a patient with X-linked Alport syndrome. Lesions of segmental glomerulosclerosis, numerous interstitial foam cells, and atypical GBMs with lamina densa splitting, subepithelial scalloping, and thinning. #renalpath #pathsky #nephsky

Some nice examples of severe tubulitis in this case of ACR 1B. Interestingly bx for new de novo DSA with with stable allograft function (~1 year post txp). No significant MVI. #renalpath #nephksy #pathsky

Alport syndrome (AS) is a hereditary glomerular disease in children characterized by hematuria, proteinuria, & progressive kidney failure. Read these Clinical Insights into a child w/autosomal dominant AS complicated w/steroid-sensitive nephrotic syndrome. link.springer.com/article/10.1...

Check out our latest “What’s New in Pathology” newsletter! June 2025 Issue: "What’s New in Medical Renal Pathology 2025: Updates on Podocytopathy and Immunofluorescence Staining in Medical Kidney" -- Read or download PDF: buff.ly/thzp6rW #Pathology #PathologyOutlines #RenalPath #PathSky

Case of IgAN in the setting cirrhosis with prominent red blood cell casts with fairly focal crescents. Pt was biopsied for gross hematuria. #renalpath #pathsky #nephsky

Nice example of cryoGN in a Sjogren pt. Somewhat early kidney presentation with some active crescents without well-developed MPGN features. IgM-k dominant, less IgG/L (type II cryo). Cryo plugs in vessels. Great micro-tubles by EM. #renalpath #nephksy #pathsky

We are looking for a 3rd renal pathologist to join our team here at UCLA. Please see the job description here: recruit.apo.ucla.edu/JPF10146. It's a great department and LA is a great city. #renalpath #pathsky

Older female pt with slowly progressive CKD, long h/o HTN. 0.5 g proteinuria. Biopsy with revealed a surprise with many podocytes demonstrating myelin figures. Main ddx includes Fabry versus drug effect (excluded in this case). pubmed.ncbi.nlm.nih.gov/35100945/. #renalpath #pathsky #nephsky

What is your leading diagnosis when seeing this interesting IgG staining pattern by IF?  #DiagnoseThis #pathology #renal #kidneypath

Episode 2 of Dr. Stephen Bonsib's new lecture series on developmental abnormalities and cystic kidney disease is now available on Youtube. This episode is part 1 of 2 focusing on congenital anomalies of the kidney & urinary tract. https://www.youtube.com/watch?v=yw712txfXi0 #renal #pathology

Txp biopsy for DGF ~1 week post txp. Glomerular congestion, fibrin thrombi in arterioles, arterial mucoid intimal edema, and cortical necrosis c/w severe acute TMA. #renalpath #pthsky #nephsky

🏅 Congratulations to UCLA Pathology's Dr. Jennifer Chia and Dr. Ting Zhang on being selected as the two recipients of this year’s Dr. Allen and Charlotte Ginsburg Fellowship in Precision Genomic Medicine!

Txp biopsy with persistent heavy proteinuria since early post-transplant period in a recipient of a peds split en-bloc graft. Pediatric donor glomerulopathy with segmental sclerosis, mesangial hypercellularity, and atypical GBM remodeling. #renalpath #nephsky #pathksy

MPO-ANCA associated vasculitis with prominent necrotizing arteritis. Interestingly, the arteritis in this case was very active despite on rare ~10% fibrocellular to fibrous crescents in glomeruli. #renalpath #pathsky #nephsky

Great case series So how do we treat a patient with IgA Nephropathy and MASH? Should we use use agents that modulate the immune system, CKD protective meds alone, GLP1-RAs? #AskRenal

Nice examples of subepithelial hump-like deposits seen in cases of recurrent C3GN and DDD. Found in 31% of recurrent C3G patient biopsies in our institutional series (indication biopsies). Exudative features also common (25% of cases). www.wjgnet.com/2220-3230/fu... #renalpath #pathsky #nephsky

Not #renalpath but an interesting autopsy case I encountered. Pictures and write up by one of our fantastic #UCLApathology residents Dr. Ross (future forensic pathologist) #foresnsicpath #autopsypath journals.lww.com/amjforensicm...

Eosinophil rich cellular rejection is often associated with vascular rejection. One of the most eosinophilic txp biopsies I've seen. ACR III (v3 lesion). Undetectable CNI level at admission. #renalpath #nephsky #pathsky

As Nephrin and anti-Nephrin goes mainstream, a call to standardize assays www.kidney-international.org/article/S008... in @kidneyint.bsky.social (who need to up their visual abstract game) #NephSky

Our department is expanding and looking for an additional renal pathologist and another GI pathologist Apply here: t.co/ZF8Y1uhQzi and t.co/SsDNqVlIBC

One of my favorite incidental/normal EM findings: crystalline pro-renin granules in JGA cells. No to be confused with any sort of paraprotein related processes. #renalpath #nephsky #pathsky

Overlap case. Recent AAA repair. AKI + hematuria. IgG-kappa MGUS. Initial infectious w/u (-). Acute GN with exudative features, monotypic IgG1-k deposits, conspicuous C3 deposits + humps in EM. Ultimately found to have + serum PCR for bacteria. PGNMID/IRGN overlap. #renalpath #nephsky #pathsky

I enjoyed this perspective piece on value of membranous antigen testing and its impact (or not) in a variety of clinical scenarios. Many great points in this piece; but the bottom line is a careful clinical history is still the best test. #renalpath #nephsky #pathsky

Case of insidious advanced presentation of IgAN/TMA as the first diagnosis. Young pt with AKI and hypertensive urgency. Bx with extensive chronic changes (>70% GS, IFTA), rare fibrocellular crescent, 4+ IgA by IF, and focal TMA. #renalpath #nephsky #Pathsky

We are looking for a 3rd renal pathologist to join our team here at UCLA. Please see the job description here: recruit.apo.ucla.edu/JPF10146. It's a great department and LA is a great city. #renalpath #pathsky

Surprised to get deposits at least vaguely microtubular-like on salvage EM tissue (dug out of the parrafin block) in this case of suspected by seronegative cryoGN. IgM-L predominant of IF. Even caught the vascular deposits. #renalpath #pathsky #nephsky

We are looking for a 3rd renal pathologist to join our team here at UCLA. Please see the job description here: recruit.apo.ucla.edu/JPF10146. It's a great department and LA is a great city. #renalpath #pathsky

We are looking for a 3rd renal pathologist to join our team here at UCLA. Please see the job description here: recruit.apo.ucla.edu/JPF10146. It's a great department and LA is a great city. #renalpath #pathsky

Absolutely horrendous kidney transplant rejection in a patient who stopped taking immunosuppressive meds. Necrotizing vasculitis, severe tubulitis, microvascular inflammation, and focal TMA. #renalp #nephsky #pathsky

When one paraprotein associated lesion is not enough. Concurrence of focal light chain cast nephropathy, monoclonal immunoglobulin deposition disease, and microangiopathy in a patient with plasma cell dyscrasia (igg-kappa). #renalpath #pathsky #nephsky

Interesting case of AL-amyloidosis, kappa type. IF showed clear kappa restriction(pictured); amyloid A IHC was very strong but mass spec confirmed AL-k amyloid (patient has a k-plasma cell dyscrasia). Never seen so much non-specific AA staining before. Mass spec FTW. #renalpath #pathsky #nephsky

Nice example of an early collapsing lesion seen by IF represented by epithelial cell hyperplasia in urinary space with abundant cytoplasmic protein reabsorption droplets staining with IgA in this image. #renalpath #pathsky #nephsky

A subtle case of ANCA associated GN. Few broad based wedge shaped segmental glomerular scars c/w old fibrous crescents. Rare active necrotizing lesions (circled). Patient had started treatment prior to biopsy. #renalpath #nephsky #pathsky

What severe decades of methamphetamine use may do the kidney vasculature. Vascular predominant TMA pattern of injury. TMA seen in ~24% of biopsies in meth users (www.sciencedirect.com/science/arti...) #renalpath #pathsky #nephsky