Case Number : Case 2878 - 19 July 2021 Posted By: Dr. Mona Abdel-Halim

I think there may have been some image manipulation which is obscuring some of the cytological detail.  It is not possible to say whether there is any fibrin deposited around the vessels.

I would vote for small vessel vasculitis (previously known and loved as leukocytoclastic vasculitis), which, in conjunction with kidney malfunction in a younger patient raises the possibility of IgA vasculitis (previously known and loved as Henoch-Schonlein Purpura).

Yes. Difficult to say if there is any fibrinoid necrosis of the small vessels, but leukocytoclastic detail is conspicuous.  So agree with Richard. 

Microscopic polyangiitis.

small vessel vasculitis

P-ANCA was positive. This was diagnosed as microscopic polyangiitis.

Pathologically, microscopic polyangiitis (MPA) may cause necrotizing arteritis that is histologically identical to that caused by polyarteritis nodosa. Madam can you please suggest. We can make diagnosis of LCV on histology and MPA diagnosis  only based on serology