The kidney biopsy specimen shown here was obtained from a 22-year-old woman found to have microscopic hematuria and mild proteinuria. Several serologic tests for autoimmune diseases gave positive results, including the tests for antibodies to double-stranded DNA and the Sm antigen.

What is the most likely diagnosis?

A. Systemic lupus erythematosus

B. Wegener granulomatosis

C. Goodpasture syndrome

D. Juvenile rheumatoid arthritis

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We will reveal the answer in next month’s issue!



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Answer to last month’s Case of the Month…

B. Clear cell carcinoma

Clear cell carcinoma of the ovary is a high-grade malignant neoplasm thought to arise from endometriosis (1). Characteristically, these tumors display several growth patterns including solid and papillary (A) and tubulocystic (B). Cells may vary from polyhedral in the solid areas to flattened in tubulocystic areas. Hobnail cells are characteristic. Tumor cell cytoplasm may range from clear to eosinophilic. Clear cell carcinomas express napsin-A and PAX8 (2). Estrogen and progesterone receptors are expressed to a variable extent, but WT1 and p53 are usually not demonstrable.

Submitted by Laura Brown, The University of Kansas School of Medicine, Kansas City, USA

References are available online.