Collapsing glomerulopathy (CG) and lesions that may resemble CG histologically in renal biopsies from patients with systemic lupus erythematosus. Collapsing.

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Collapsing glomerulopathy (CG) and lesions that may resemble CG histologically in renal biopsies from patients with systemic lupus erythematosus. Collapsing glomerulopathy (CG) and lesions that may resemble CG histologically in renal biopsies from patients with systemic lupus erythematosus. (A) CG. There is segmental collapse of the capillary tuft with overlying swollen and hyperplastic epithelial cells, some of which contain protein resorption droplets. (B) Lupus nephritis with a cellular crescent. In this glomerulus, the cells of the crescent are plump and not spindle-shaped, which can lead to the impression of CG. However, there is endocapillary proliferation, as well as somewhat subtle, segmental fibrinoid necrosis with disruption of the glomerular basement membrane (arrow), which are not features seen in CG. Electron microscopy (not shown) demonstrated mesangial and segmental subendothelial deposits. (C) Pauci-immune crescentic GN. Portions of the glomerulus not involved by the crescent do not show endocapillary hypercellularity, a feature that is also seen with CG. However, note the spindle shape of some of the cells, as well as some fibrin within the cellular crescent, features much more typical of true crescents than of the “pseudocrescents” of CG. All three panels show tissue stained with Jones methenamine silver stain.(Original magnification, ×400; Bar, 50 μm.)‏ Mark Haas CJASN 2012;7:878-880 ©2012 by American Society of Nephrology