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Top row (a–d): a case of anti–glomerular basement membrane (GBM) disease (case 12)…
Figure 1
Top row (a–d): a case of anti–glomerular basement membrane (GBM) disease (case 12) with segmental membranous nephropathy (MN). (a) Glomerulus with a cellular crescent (hematoxylin and eosin [H&E] stain, original magnification ×400). (b) Silver stain shows a compressed glomerular tuft with no obvious spikes or lucencies along the GBM (original magnification ×4000). (c) Linear IgG staining (immunofluorescence, original magnification ×400). (d) Electron microscopic image showing segmental subepithelial deposits. Bottom row (e−h): a case of PLA2R-positive MN with concomitant p-ANCA (case 8). (e) Glomerulus with a cellular crescent (H&E stain, original magnification ×400). (f) Silver stain highlights capillary wall irregularities (fine lucencies and spikes) in the same glomerulus that contains a cellular crescent (original magnification ×400). (g) An anti-PLA2R antibody shows diffuse granular positivity along the GBM (immunofluorescence, original magnification ×400). (h) Electron microscopy confirms diffuse subepithelial deposits.
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