Figure 1.
Renal histology by LM of patient with CINAC from Paraguay. (a) Overview of part of the biopsy showing striped fibrosis. (b) Asterisk marks tubule with cells containing enlarged argyrophilic lysosomes and thickened basement membrane. (c) Atrophic proximal tubule with multiple epithelial cells containing enlarged argyrophilic lysosomes (arrows). (d) Atrophic proximal tubule with decreased epithelial height containing normal-sized to enlarged lysosomes. (e) Details of d with arrows pointing toward proximal epithelial cells containing enlarged, dysmorphic lysosomes. (a–e) Periodic acid–Schiff methenamine staining. The argyrophilic granules were previously demonstrated to be lysosomes by immunofluorescent staining for the lysosomal markers cathepsin B and LAMP1 in combination with Periodic acid–Schiff methenamine staining.4 CINAC, chronic interstitial nephritis in agricultural communities; LM, light microscopy.