case_images: PMC5715205_01
case_images: A: Glomerulus shows mesangial matrix expansion, thickened basement membranes, and megakaryocytes (arrows) on LM (H&E, original magnification 400x). B: Double contours are present on PASM section (original magnification 400x). C: Interstitium shows heavy inflammatory infiltrate with megakaryocytes (arrows) (H&E, original magnification 200x). D: The immunoreactivity for LAT-1 highlights megakaryocytes (arrows) (original magnification 400x). E: A granulocyte (asterisk) inside the lumen of a glomerular capillary. Thin arrows indicate finely granular electron-dense material in the subendothelium due to the high rate of protein reabsorption. Large arrows show podocyte effacement (TEM, original magnification 8,900x). F: A granulocyte (G) inside a capillary lumen; expansion of the mesangial matrix (asterisks), subendothelial collection of finely granular electron-dense material due to protein reabsorption (thin arrows); a podocyte (P) on the outer side of the basement membrane shows partial podocyte fusion (large arrows) (TEM, original magnification 14,000x)
case_images: CNCS-5-070-01.jpg
case_images: PMC5715205_01_CNCS-5-070-01.jpg
case_images: Figure1
case_images: All glomeruli showed diffuse mesangial matrix expansion (Figure 1A), thickening of glomerular basement membrane, and rare double contours on PAS-M sections (Figure 1B). Large atypical cells with multi-lobed nuclei were observed in the glomerular capillaries (Figure 1A), in cortical and medullary tubulointerstitium, associated with heavy infiltrate formed mainly by granulocytes (Figure 1C). CD 61 confirmed that the large atypical cells were megakaryocytes (Figure 1D). Congo red staining was negative. There was activation of the podocytes with segmental foot effacement, more pronounced in some glomeruli(Figure 1E, F). 
case_images: PMC5715205_02