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. 2010 Aug;3(4):397-401.
doi: 10.1093/ndtplus/sfq081. Epub 2010 May 5.

Renal allograft granulomas in the early post-transplant period

Jessica B Lapasia  1 , Neeraja Kambham  2 , Stéphan Busque  3 , Jane C Tan  4
Affiliations

Renal allograft granulomas in the early post-transplant period

Jessica B Lapasia et al. NDT Plus. 2010 Aug.
No abstract available

Keywords: allograft; granulomas; interstitial; nephritis; transplantation.

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Figures

Fig. 1
Fig. 1
Histological features of renal allograft biopsies. of case 1 (A,B), case 2 (C,D) and case 3 (E,F) (A) Ill-defined collections of epithelioid histiocytes are seen in the medulla, centred around the vasa recta (arrow). Patchy granulomatous inflammation was seen in the cortex as well, but there was no evidence of vasculitis, crescents or infectious aetiology. (B) The granulomatous inflammation completely resolved with corticosteroid therapy, as seen in a repeat biopsy performed 5 weeks later. (C) Renal allograft biopsy shows granulomatous tubulointerstitial inflammation (arrow). (D) A GMS stain revealed fungal yeast forms within the granulomas, measuring 5–10 μm in diameter and morphologically suggestive of Histoplasma species (arrow head). (E) The first biopsy revealed tubulointerstitial non-caseating granulomas and some were periglomerular, compressing the capillary tufts and disrupting the Bowman's capsules (arrow). There were no glomerular crescents or necrotizing lesions. (F) A repeat biopsy revealed intimal arteritis (asterisk) along with persistent granulomatous inflammation, raising the possibility of coexistent acute vascular rejection.
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