Histologic features differentiating BK virus nephropathy from acute rejection
| Feature | BK virus nephropathy | Cell-mediated rejection | Antibody-mediated rejection |
|---|---|---|---|
| Interstitial inflammation | More CD20+ cells, plasma cells, neutrophils Clusters of CD68+ cells |
More T cells, eosinophils | No |
| Kidney localization | Medullary > cortical Geographic involvement |
Cortical | Cortical |
| Tubulitis | Predominantly in infected tubules | Distant from infected tubules, more severe | No |
| Vascular inflammation | No | Yes | Yes |
| Glomerulitis | No | No | Yes |
| Transplant glomerulopathy | No | No | Yes |
| C4d+ PTCs | No | No | Yes |
PTC, peritubular capillary.