Click on images for larger views. Vessels are congested and cuffed by inflammatory cells. There is multifocal perivascular hemorrhage. Hemorrhage, thrombosis and inflammatory cells replace urothelium and infiltrate underlying smooth muscle. Vessel walls are multifocally replaced by necrotic debris, neutrophils, macrophages and fungal hyphae.
Some vessels contain fibrin thrombi.
Multifocally, tubular epithelium is necrotic and replaced by abundant fungal hypha and pseudohyphae admixed with neutrophils and fewer macrophages. PAS staining illustrates the branching nature of hyphae and the segmentation of pseudohyphae. Case 17-2 . Scattered venous thrombosis is accompanied by pyogranulomatous inflammation replacing vascular walls and extending into the interstitium. Nephritis, tubulointerstitial, pyogranulomatous, multifocal, moderate, with vasculitis, fibrin thrombi, and few yeast.