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Electron Microscopy for Pathologists: Kidney Pathology
F. Focal segmental glomerulosclerosis

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Image 1 of 4
Focal segmental glomerulosclerosis is associated clinically with severe proteinuria or the nephrotic syndrome. Hematuria is also commonly observed by urinalysis. On electron microscopy, foot process fusion is common.

 

 

Focal segmental glomerulosclerosis
   

Image 2 of 4
Widespread visceral foot process fusion is identified. Here the lamina densa is prominent, but no electron dense deposits are present.

 

 

 

 

Focal segmental glomerulosclerosis
Image 3 of 4
Fusion and flattening of the foot processes is present along with mild microvillous transformation of the foot process. The GBM is otherwise of normal thickness. No electron dense deposits are found.
Focal segmental glomerulosclerosis
   
Image 4 of 4
In this image, at the top is an unaffected portion of glomerulus in which podocytes are not fused. Below, in the zone of GBM wrinkling and collapse, focal foot process fusion can be seen.
Focal segmental glomerulosclerosis

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