Evolution of human kidney allograft pathology diagnostics through 30 years of the Banff classification process

Figure 4 Diagnostic lesions. A: Acute Banff lesion of glomerulitis. There is segmental glomerulitis (g1) (arrows) characterized by mononuclear inflammatory cell infiltration and endothelial cell enlargement resulting in partial to complete occlusion of capillary lumena. Glomerulitis is one of the key lesions of antibody-mediated rejection. (Period acid-Schiff, ×400); B Morphologic features of mixed antibody-mediated and T cell-mediated rejection with both acute and chronic lesions. There is almost global glomerulitis (yellow arrows) with segmental foci of glomerular basement membrane thickening (blue arrows) suggestive of early transplant glomerulopathy along with diffuse interstitial inflammation (i3) (orange arrows) and peritubular capillaritis (black arrows). An artery included shows severe intimal fibrous thickening (neo-intima formation) without duplication of elastica, (Period acid-Schiff, × 200); C: Mixed acute and chronic Banff diagnostic lesions of rejection. There is segmental glomerulitis (black arrow), peritubular capillaritis (orange arrows), and foci of tubulitis in mildly to moderately atrophic tubules within the scarred cortex (yellow arrows) (Jones Methenamine Silver, × 400).