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Diagnosis: Insudative Tubular Lesions in Diabetic Nephropathy

Although not as famous as capsular drops or fibrin caps, these lesions are part of the spectrum of insudative lesions that can be found in diabetic nephropathy.

The tubular lesion corresponds to what Dr Stout and colleagues described as heterogenous lucent insudative lesions (Stout LC, et al. Insudative lesions--their pathogenesis and association with glomerular obsolescence in diabetes: a dynamic hypothesis based on single views of advancing human diabetic nephropathy. Hum Pathol. 1994 Nov;(11):1213-27 [PubMed link]). These lesions can be found within glomeruli as heterogenous lucent capsular drops as well as in proximal convoluted tubules between the tubular basement membrane and the epithelial cells. It was hypothesized in that same article that the “lucent deposits migrate from glomerular capillary subendothelial spaces through adhesions into Bowman’s capsule and extend down the wall of the proximal tubule.” (Comment by Dr Julie Riopel: Link)

Thank you very much to Boonyarit Cheunsuchon, MD, associate professor, Department of Pathology, Siriraj Hospital, Mahidol University, Bangkok, Thailand, for sharing this case with us and allowing us to learn from it.

Visit the Chapter: Diabetic Nephropathy of our Tutorial.

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References

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