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Microscopic Description: Kidney: The kidney appears reduced in size. The capsular surface is irregular and there is a marked reduction in the number of normal proximal convoluted tubules. Most of the cortex is occupied by small tubules lined by cells that stain more lightly than normal.
Many of these cells have karyomegalic nuclei with chromatin margination and eosinophilic intranuclear inclusion bodies. Their cytoplasm is pale and contains granular eosinophilic material. Other degenerative changes seen in the pale tubules include lining by a reduced number of cells, flattening, loss and anisokaryosis and anisocytosis of lining cells and accumulation of intraluminal debris. There is multifocal mild to moderate tubular dilation and the dilated tubules show similar degenerative changes.
There is mild multifocal interstitial fibrosis and scattered accumulation of granular brown material in tubular lining cells, and possibly in macrophages. Much of the discussion below is the result of personal communications from Dr. Monette and Dr. Ben Roediger. While milder lesions associated with renal tubular inclusions were previously reported in mice1,2, as discussed by the contributor, description of the severe form of murine inclusion body nephropathy IBN , as seen in the present case, was first reported in as part of an article on aging changes in NOD scid gamma NSG female mice.
The article described moderate to marked renal tubular degeneration and necrosis with two types of intranuclear inclusions within renal cortical and medullary tubular epithelial cells numerous large pale inclusions filling the nucleus, and occasional small densely staining inclusions surrounded by a clear halo; as observed in this case - the presence of these two distinct types of inclusions may be of diagnostic value to pathologists encountering these lesion for the first time.