National Renal Pathology E.Q.A. Scheme
Circulation Q
This document gives information on individual cases in
circulation Q of this scheme. It contains no personal details
of participants.
Cases included:
Q 78
Q 79
Q 82
Q 83
End
A click on the 
icon should provide an image from the material
circulated. Some of the images are composites - remember to
scroll the image to see parts beyond the bottom of your screen.
WARNING The image files associated with this
document are selected by the Organiser in an attempt to
illustrate the relevant features of the material which was
circulated in the EQA scheme. They are intended as a 'aide
memoire' for participants who may no longer have the slides for
review.
They are NOT intended as 'good examples' or as
teaching material. In some instances the images (especially the
second image) may be chosen to illustrate a feature which led
some participants to a wrong diagnosis.
Case Response Analysis
Circulation: Q
Case number: 78
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Number of responses:61 . Date of analysis: 2 JUN 97
Clinical:
Normal renal function but 5.2g proteinuria per day. No other clinical
details.
Specimen:
H&E, PAMS, E.M prints.x2, IPx transps.x2
Diagnostic categories: Score:
1 Membranous glomerulonephritis 6.85
2 Mesangiocapillary glomerulonephritis 1.85
3 Lupus nephritis 0.48
4 Dense deposit disease 0.49
5 Minimal change nephropathy (with IgM) 0.16
6 Diffuse proliferative glomerulonephritis 0.16
Asterisks (if any) indicate dangerous diagnoses.
Highest scoring diagnosis was 1 with 6.85
Secondary diagnoses and comments (if any):
Exclude SLE*17. Exclude Hep. B*1. Exclude amyloid*1. Exclude cryo.*1. Odd
variant of membranous - iregular sclerosis/proliferation?*3.
Poor silver stain*9. Poor e.m.*4. Inadequate clinical info*9.
Original report and further information (if any):
Mesangiocapillary glomerulonephritis, probably type III
Circulation: Q
Case number: 79
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Number of responses:61 . Date of analysis: 2 JUN 97
Clinical:
Hypertension, proteinuria & haematuria.
Specimen:
H&E, PAMS, EM prints x2, IPx. transp. x1.
Diagnostic categories: Score:
1 IgA nephropathy 9.44
2 Focal segmental glomerulosclerosis 0.16
3 Hereditary nephropathy 0.23
4 Mesangiocapillary glomerulonephritis 0.16
Asterisks (if any) indicate dangerous diagnoses.
Highest scoring diagnosis was 1 with 9.44
Secondary diagnoses and comments (if any):
Immuno. too faint*1. Inadequate clinical info*7. Exclude SLE*1. Exclude
cirrhosis*1. Exclude Alport's*4. Hypertension too*1.
Original report and further information (if any):
IgA nephropathy. The presence of capillary loop depsoits may imply a
poorer prognosis, but other adverse features not present.
Circulation: Q
Case number: 82
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Number of responses:61 . Date of analysis: 2 JUN 97
Clinical:
56y.o. woman. Primary Sjogren's. BP 190/100. Mild renal impairment,
creatinine 135, proteinuria 1g/day. IF: modest granular mesangial IgM,
glomeruli only. Other Igs and complement negative. EM: no glomeruli
available.
Specimen:
H&E, PAS
Diagnostic categories: Score:
1 Hypertension 0.75
2 Interstitial nephritis / Sjögren's syndrome 7.74
3 Mesangial proliferative glomerulonephritis 0.07
4 Focal segmental glomerulosclerosis 0.03
6 Cryoglobulinaemia / Waldenstrom's macroglobulinaemia 0.95
7 Microangiopathy 0.25
8 Mixed connective tissue disease 0.20
9 Myeloma 0.02
10 Some responses suggest 2 and 5 should be merged 0.00
Asterisks (if any) indicate dangerous diagnoses.
Highest scoring diagnosis was 2 with 7.74
Secondary diagnoses and comments (if any):
Need E.M.; reprocess paraffin*4. Meth. Ag*4. Congo red*7. Exclude
myeloma*3. Exclude SLE*1. Drug history *1.
Hypertension too*6. Lymphocyte markers - exclude lymphoma*6.
Inadequate material*1.
Original report and further information (if any):
Interstitial nephritis of Sjögren's syndrome and hypertensive changes.
Subsequently GFR decreased despite treatment and hypertension worsened.
Neutropenia and pharyngitis attributed to azathioprine treatment.
Circulation: Q
Case number: 83
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Number of responses:1 . Date of analysis: 2 JUN 97
Clinical:
Diagnostic categories: Score:
1 'Reninoma' 0.00
2 Metanephric adenoma 0.00
3 Hamartoma 0.00
4 Neurofibroma 0.00
5 Renal artery stenosis 0.00
6 Nephrogenic adenofibroma 0.00
7 Dysplastic kidney 0.00
8 Medullary interstitial neoplasm 0.00
9 Peculiar form of medullary sponge kidney 0.00
10 Don't know or diagnoses not on above list (see below) 0.00
Asterisks (if any) indicate dangerous diagnoses.
Highest scoring diagnosis was 1 with 0.00
Secondary diagnoses and comments (if any):
Further diagnoses: Mesoblastic nephroma*3, 'phyllodes-like lesion'*1,
'Mesenchymal nodule
Original report and further information (if any):
Links to cases in this document:
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Q 78
Q 79
Q 82
Q 83
Home Page
CWIS
Pathology EQA
Last updated: 2 JUN 97
Dr Peter Furness, PhD, MRCPath.
Department of Pathology,
Clinical Sciences Building,
Leicester Royal Infirmary,
P. O. Box 65,
Leicester, U.K.
Tel: (0116)2584582 Fax: (0116) 2584573
Email: pnf1@le.
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