Final Diagnosis (Case 5)

1. CHRONIC ALLOGRAFT NEPHROPATHY, MILD TO MODERATE, WITH ONE OF TEN GLOMERULI SCLEROTIC (cg0, ci2, ct2, cv1, ah1).
2. BORDERLINE CHANGE, INSUFFICIENT FOR THE DIAGNOSIS OF ACUTE REJECTION (g0, i1, t2, v0).

Previous Biopsies on this Patient:
None

TPIS Related Resources:
Kidney Transplant Topics

Gross Description - Case 5

Microscopic Description - Case 5

1. Glomerulosclerosis
1.1 Number of glomeruli	(10)
1.2 Number globally sclerotic	(1)
1.3 Segmental sclerosis	( )YES		(X)NO
2. Glomerulitis	(X)0	( )1	( )2	( )3
3. Interstitial inflammation	( )0	(X)1	( )2	( )3
4. Intimal arteritis	(X)0	( )1	( )2	( )3
5. Tubulitis	( )0	( )1	(X)2	( )3
6. Arteriolar hyalin	( )0	(X)1	( )2	( )3
7. Chronic glomerular change	(X)0	( )1	( )2	( )3
8. Interstitial fibrosis	( )0	( )1	(X)2	( )3
9. Tubular atrophy	( )0	( )1	(X)2	( )3
10. Vascular intimal sclerosis	( )0	(X)1	( )2	( )3
11. Other Findings	PAS stains shows single focus of atrophic t2 tubulitis; previous biopsy 97-1948, 1/26/97 showed mild chronic allograft nephropathy; one episode of mild rejection documented in April 1996; primary disease is diabetes.
12. Diagnostic categories
12.1 Acute rejection (KDAR_) [g,i,t,v codes]:	( ) Grade 0 (Normal)(i0, t0, v0) (X) Grade B (Borderline)(i0-1, t0-1, v0) ( ) Grade 1 (Mild)(i1-3, t2, v0) ( ) Grade 2 (Moderate)(i1-3, t1-3, v1-2) ( ) Grade 3 (Severe)(i1-3, t1-3, v3)
12.2 Chronic allograft nephropathy (KDCR_) [cg,ci,ct,cv codes]:	(X) Grade 1 (Mild)(ci1-3, ct2, cv0) (X) Grade 2 (Moderate)(ci1-3, ct1-3, cv1-2) ( ) Grade 3 (Severe)(ci1-3, ct1-3, cv3)
12.3 Drug-associated changes (KDDR):	( )
12.4 Acute tubular necrosis (KDAT):	( )
12.5 Donor diseases (KDDO):	( )
12.3 Other:	( ) Recurrent disease ( ) Subcapsular injury ( ) CMV ( ) Obstruction ( ) Vascular thrombosis		( ) Pyelonephritis ( ) PTLD ( ) Reflux ( ) Miscellaneous