From: "Bo Van Damme" <baudewijn.vandamme@uz.kuleuven.ac.be>
To: <nephnppt@mailman.srv.ualberta.ca>
Sent: Thursday, October 12, 2006 9:16 AM
Subject: RE: [Nephnppt] FW: Glomerulomegaly

Dear Nephronauts:

Glomerulomegaly is quite easy to recognise: The diameter is larger than 200-250 microns, but this needs a measuring device, which is present in most systems for virtual microscopy
Also the simple morphology of the glomeruli indicates glomerulomegaly: the mesangium has too many branches (normal is 3 to 5 ill defined segments) see fig 1 of ppt file
And the mesangial segments bear too many capillaries: normally 10-20
Another (more subtle) sign is that the ampulla of the afferent arteriole is wide and is situated within the contour of the capsule of Bowman (fig2)
Usually large glomeruli are accompanied by hypertrophic tubules: they have irregular contours, due to formation of diverticuli, mostly in the proximal tubule (fig 1). It is common to find segmental hyalinisations in biopsies with large glomeruli.
The clinical context is slightly decreased renal function, accompanied by mild to moderate proteinuria. Of course large glomeruli are seen in all types of (focal) destruction of glomeruli due to glomerulonephritis.

B. Van Damme
Professor of Pathology
UZ-KULeuven,
Leuven, Belgium
 

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