AJKD Atlas of Renal Pathology: IgG4-Related Tubulointerstitial Nephritis  Behzad Najafian, MD, Agnes B. Fogo, MD, Mark A. Lusco, MD, Charles E. Alpers, MD  American Journal of Kidney Diseases  Volume 69, Issue 4, Pages e19-e20 (April 2017) DOI: 10.1053/j.ajkd.2017.02.001 Copyright © 2017 National Kidney Foundation, Inc. Terms and Conditions

Figure 1 IgG4-related TIN with abundant plasma cells (Jones silver stain). The presence of nests of inflammatory cells surrounded by collagen bundles (bird’s eye pattern) is a typical finding. There might be frequent interstitial eosinophils as seen in this case (upper right). American Journal of Kidney Diseases 2017 69, e19-e20DOI: (10.1053/j.ajkd.2017.02.001) Copyright © 2017 National Kidney Foundation, Inc. Terms and Conditions

Figure 2 IgG4-related TIN with storiform fibrosis where fibroblasts and inflammatory cells arrange in pattern resembling spokes of a cartwheel (Jones silver stain). American Journal of Kidney Diseases 2017 69, e19-e20DOI: (10.1053/j.ajkd.2017.02.001) Copyright © 2017 National Kidney Foundation, Inc. Terms and Conditions

Figure 3 IgG4-related TIN with immunoperoxidase staining that shows abundant interstitial IgG4-positive plasma cells (anti-IgG4 immunoperoxidase stain). American Journal of Kidney Diseases 2017 69, e19-e20DOI: (10.1053/j.ajkd.2017.02.001) Copyright © 2017 National Kidney Foundation, Inc. Terms and Conditions

Figure 4 IgG4-related TIN with focal granular tubular basement membrane deposits staining with IgG, a finding present in >80% of cases. On the right side, there is focal granular Bowman’s capsule deposits staining with IgG (immunofluorescence anti-IgG). American Journal of Kidney Diseases 2017 69, e19-e20DOI: (10.1053/j.ajkd.2017.02.001) Copyright © 2017 National Kidney Foundation, Inc. Terms and Conditions

Figure 5 IgG4-related TIN with immune-type deposits (arrow) along the tubular basement membrane (electron microscopy). American Journal of Kidney Diseases 2017 69, e19-e20DOI: (10.1053/j.ajkd.2017.02.001) Copyright © 2017 National Kidney Foundation, Inc. Terms and Conditions