case_images: PMC5438001_01
case_images: Glomerulus showing a cellular crescent with fibrinoid necrosis (Jones methenamine silver stain x 200).
case_images: CNCS-4-005-01.jpg
case_images: PMC5438001_01_CNCS-4-005-01.jpg
case_images: Figure1
case_images: Light microscopy revealed 4 corticomedullary cores with 28 glomeruli, 5 of which were obsolescent. 16 glomeruli demonstrated cellular crescents with marked fibrinoid necrosis (Figure 1).
case_images: Obsolescent glomerulus with adjacent multinucleated giant cell (H & E x 200).
case_images: CNCS-4-005-02.jpg
case_images: PMC5438001_01_CNCS-4-005-02.jpg
case_images: Figure2
case_images: Obliteration of Bowman's capsules and periglomerular giant cells were noted in a few glomeruli (Figure 2).
case_images: Bright linear IgG staining of the glomerular capillary loops on immunofluorescence.
case_images: CNCS-4-005-03.jpg
case_images: PMC5438001_01_CNCS-4-005-03.jpg
case_images: Figure3
case_images: Bright capillary loop staining was seen with antisera specific for IgG (2+; scale trace through 3+), C3 (1+), and kappa and lambda light chains (both 2+) (Figure 3).
case_images: Necrotizing arteritis with transmural inflammation in the lung instertitium (H & E x 200).
case_images: CNCS-4-005-04.jpg
case_images: PMC5438001_01_CNCS-4-005-04.jpg
case_images: Figure4
case_images: The CT-guided lung biopsy revealed multiple cores with necrotizing granulomatous inflammation and focal vasculitis with associated multinucleated giant cells (Figure 4, Figure 5).
case_images: Multinucleated giant cells in the lung (H & E x 400).
case_images: CNCS-4-005-05.jpg
case_images: PMC5438001_01_CNCS-4-005-05.jpg
case_images: Figure5
case_images: The CT-guided lung biopsy revealed multiple cores with necrotizing granulomatous inflammation and focal vasculitis with associated multinucleated giant cells (Figure 4, Figure 5).