Pathology – Research and Practice 209 (2013) 75–82 Contents lists available at SciVerse ScienceDirect Pathology – Research and Practice j ourna l ho mepage: www.elsevier.com/locate/prp Original article Pauci-immune necrotizing crescentic glomerulonephritis with crescentic and full moon extracapillary proliferation: Clinico-pathologic correlation and follow-up study Mehtat Unlu a,∗ , Saba Kiremitci b , Arzu Ensari b , Yasemin Ozluk c , Isin Kilicaslan c , Binnaz Handan Ozdemir d , Deniz Ates e , Dilek Ertoy Baydar e , Ipek Isik Gonul f , Leyla Memis f , Banu Sarsik g , Sait Sen g , Bahar Akkaya h , Diclehan Orhan i , Gulfiliz Gonlusen j , Hulya Ellidokuz k , Sibel Ada l , Caner Cavdar l , Tulin Akagun m , Sevil Kamali n , Kenan Aksu o , Veli Yazisiz p , Saime Paydas q , Alper Soylu r , Sulen Sarioglu a a Department of Pathology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey b Department of Pathology, Ankara University, Faculty of Medicine, Ankara, Turkey c Department of Pathology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey d Department of Pathology, Baskent University, Faculty of Medicine, Ankara, Turkey e Department of Pathology, Hacettepe University, Faculty of Medicine, Ankara, Turkey f Department of Pathology, Gazi University, Faculty of Medicine, Ankara, Turkey g Department of Pathology, Ege University, Faculty of Medicine, Izmir, Turkey h Department of Pathology, Akdeniz University, Faculty of Medicine, Antalya, Turkey i Department of Pediatric Pathology, Hacettepe University, Faculty of Medicine, Ankara, Turkey j Department of Pathology, Cukurova University, Faculty of Medicine, Adana, Turkey k Department of Biostatistics and Medical Information, Dokuz Eylul University, Izmir, Turkey l Department of Nephrology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey m Department of Nephrology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey n Department of Romatology, Istanbul University, Faculty of Medicine, Istanbul, Turkey o Department of Romatolgy, Ege University, Faculty of Medicine, Izmir, Turkey p Department of Romatolgy, Akdeniz University, Faculty of Medicine, Antalya, Turkey q Department of Nephrology, Cukurova University, Faculty of Medicine, Adana, Turkey r Department of Pediatric Nephrology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey a r t i c l e i n f o Article history: Received 25 December 2011 Received in revised form 5 October 2012 Accepted 11 October 2012 Keywords: Extracapillary proliferation Crescent Full moon Prognosis Pauci-immune necrotizing crescentic glomerulonephitis a b s t r a c t The prognostic value of the type and extent of extracapillary proliferation (ECP) in pauci-immune necro- tizing crescentic glomerulonephitis (PIGN) was evaluated in this study. In 141 PIGN cases, all glomeruli with ECP were grouped according to type (cellular, fibrocellular and fibrous) and extent of the lesions in Bowman’s space; (segmental, semicircumferential and circumfer- ential, which might be termed full moon-FM). Cases with cellular and fibrous lesions involving ≥50% of glomeruli with ECP were classified as cellular and fibrous groups, respectively, while the remaining cases were classified as fibrocellular. Cases with segmental and circumferential (FM glomerulus) lesions involving ≥50% of glomeruli with ECP were classified as ECPI and ECPIII (FM) groups, respectively, while the rest were classified as ECPII. All the cases were classified according to Berden et al. Significant results were only nearly obtained for the FM group, including the need for dialysis. The Cox regression model revealed a 2.6-fold risk for FM cases regarding dialysis requirement. We propose that the percentage of FM glomeruli should be noted in the pathology report, and cases with more than 50% of FM glomeruli (FM group) should be identified in the group with increased risk of dialysis requirement. Our series also suggests that classification according to Berden et al. is of clinical relevance. © 2012 Elsevier GmbH. All rights reserved. ∗ Corresponding author. Tel.: +90 232 4121415; fax: +90 232 2777274. E-mail address: mehtat.unlu@deu.edu.tr (M. Unlu). 0344-0338/$ – see front matter © 2012 Elsevier GmbH. All rights reserved. http://dx.doi.org/10.1016/j.prp.2012.10.012