A Case of Weber-Christian Disease With Collapsing Glomerulopathy Nilay Nahar, MD, Victoriano Pardo, MD, Sanghamitra Sadhu, MD, Larry Young, MD, Nora Gonzalez, MD, Edgar A. Jaimes, MD  American Journal of Kidney Diseases  Volume 48, Issue 3, Pages 484-488 (September 2006) DOI: 10.1053/j.ajkd.2006.05.025 Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

Fig 1 Biopsy specimen of a subcutaneous nodule shows (A) fat necrosis with destruction of adipocytes and necrotic inflammatory cells and (B) fat cells surrounded by numerous mononuclear and giant cells, as well as foam cells. American Journal of Kidney Diseases 2006 48, 484-488DOI: (10.1053/j.ajkd.2006.05.025) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

Fig 2 Light microscopic picture of a glomerulus shows severe capillary collapse. (A) Most of the glomerular volume consists of swollen vacuolated hyperplastic visceral epithelial cells containing protein reabsorption droplets. Capillaries are collapsed and frequently imperceptible. (Hematoxylin and eosin; original magnification ×350.) (B) Glomerulus with collapsed capillary loops in several lobules. (Jones silver methenamine; original magnification ×300.) American Journal of Kidney Diseases 2006 48, 484-488DOI: (10.1053/j.ajkd.2006.05.025) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

Fig 3 Light microscopy of the interstitium shows mixed interstitial inflammation with predominance of macrophages. Tubules show degenerative changes and tubulitis. (Hematoxylin and eosin; original magnification ×400.) American Journal of Kidney Diseases 2006 48, 484-488DOI: (10.1053/j.ajkd.2006.05.025) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

Fig 4 Light microscopy of the interstitium shows abundant foam cells and some epithelioid cells. A giant cell nucleus also is evident (arrow). There is severe degeneration of tubular cells and tubulitis. Some apoptotic interstitial nuclei are seen. (Hematoxylin and eosin; original magnification ×400.) American Journal of Kidney Diseases 2006 48, 484-488DOI: (10.1053/j.ajkd.2006.05.025) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

Fig 5 Electron microscopy shows collapsed capillary surrounded by hypertrophic visceral epithelial cells that contain variegated granules and vacuoles that fill Bowman space. (Original magnification ×15,000.) American Journal of Kidney Diseases 2006 48, 484-488DOI: (10.1053/j.ajkd.2006.05.025) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

Fig 6 Electron microscopy shows large macrophages loaded with lysosomes and phagolysomes containing a variety of lipid bodies that fill the interstitial spaces and “hug” neighboring tubular basement membranes. (Original magnification ×15,000.) American Journal of Kidney Diseases 2006 48, 484-488DOI: (10.1053/j.ajkd.2006.05.025) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions

Fig 7 Electron microscopy of an intertubular capillary shows a cell with cytoplasmic characteristics of a macrophage adherent to the capillary wall. A similar cell process is approaching the capillary wall in the same area. (Original magnification ×15,000.) American Journal of Kidney Diseases 2006 48, 484-488DOI: (10.1053/j.ajkd.2006.05.025) Copyright © 2006 National Kidney Foundation, Inc. Terms and Conditions