December 2017

Signalment (AFIP #1741589):  Dog of unknown age and gender.

HISTORY:  This dog had proteinuria, hypoproteinemia, and had lost more than 2 grams of protein in the urine in a 24-hour period.

HISTOPATHOLOGIC DESCRIPTION:  A (H&E):  Kidney:  Diffusely, glomerular tufts are globally expanded by variable amounts of amorphous, extracellular, hyaline to finely fibrillar waxy material (amyloid) that compresses capillaries and obscures glomerular architecture.  Glomerular tufts are hypocellular with pyknosis and rare karyorrhectic debris (necrosis), and frequently fill Bowman’s space and adhere to Bowman’s capsule (synechia).  Multifocally, tubular epithelium contains one or more of the following changes: swollen and vacuolated with vesiculate nuclei (degeneration); shrunken, hypereosinophilic with pyknosis (necrosis); increased basophilia, occasional mitoses and irregularly spaced hyperchromatic nuclei (regeneration); or contain brown cytoplasmic globular pigment (hemosiderin).  Multifocally, tubules are ectatic, lined by attenuated epithelium, and contain abundant eosinophilic homogenous proteinaceous material (proteinosis) or tubular lumina contain necrotic cellular debris, granular deeply basophilic material (mineral) or round birefringent crystals with radiating lines (calcium carbonate).  Multifocally within the interstitium, there are small amounts of amyloid, mild congestion, minimal hemorrhage, and few lymphocytes and plasma cells. 

B (Congo red):  Diffusely, glomerular tufts are expanded by abundant congophilic material that displays bright green birefringence under polarized light (amyloid).

MORPHOLOGIC DIAGNOSIS:  Kidney:  Amyloidosis, glomerular, global, diffuse, severe with multifocal tubular epithelial degeneration, necrosis, and rare regeneration, breed unspecified, canine.

CONDITION:  Glomerular amyloidosis










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