Which light microscopy findings are characteristic of poststreptococcal glomerulonephritis?

Updated: Dec 16, 2020
  • Author: Duvuru Geetha, MD, MRCP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Light microscopy findings are as follows:

  • The most striking finding is hypercellularity of the glomeruli. All glomeruli are affected (diffuse) and usually to an approximately equal degree. The glomerular tufts are larger than normal, and the cells are more numerous.

  • The cell types typically present include endothelial and mesangial cells and migrant inflammatory cells, which include polymorphonuclear leukocytes and monocytes. [28]

  • Polymorphonuclear leukocytes are present in large numbers, hence the term exudative glomerulonephritis.

  • Necrosis in the glomerular tuft is not typically found.

  • The individual lobules are wider than usual and may have a clubbed appearance.

  • Generally, the glomerular capillary walls are not thick.

  • In some patients, crescent formation may be found, but usually, only a small percentage of glomeruli are affected by crescents.

  • The tubules are normal in the majority of cases.

  • When proteinuria is present, hyaline droplets (protein reabsorption droplets) may be present in the proximal convoluted tubules.

  • In patients with severe exudative glomerulonephritis, polymorphonuclear leukocytes may be present in the lumen.

  • The degree of interstitial involvement is variable. The interstitial areas show edema and infiltration with polymorphonuclear leukocytes and mononuclear cells. The arteries and arterioles are normal.


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