Case of the Week 297

A patient was noted to have rapidly increasing serum creatinine 4 months after receiving a renal allograft. A renal biopsy was performed, which revealed small oval/elongate objects within the renale tubules.  (CLICK ON IMAGES TO ENLARGE).  A variety of stains and additional studies were performed:H&E, 200x H&E, 400x H&E, 1000x (note how tiny the structures inside the renal tubule cells are) The structures were partially acid fast (Ziehl Neelsen, 1000x) A Ryan's trichrome performed on tissue nicely highlighted the objects (1000x) A urine specimen stained with Ryan's trichrome also showed these structures.By electron microscopy, the objects were seen within vacuoles in the renal tubular cells. Higher magnification by EM:
Source: Creepy Dreadful Wonderful Parasites - Category: Pathologists Source Type: blogs