Cryoglobulinemic glomerulonephritis. The glomerulus shows global occlusion of peripheral capillary lumina by numerous infiltrating monocytes. Segmental intracapillary pink-staining immune thrombi (arrows), likely representing cryoglobulin deposits, are seen. There is widespread duplication of the glomerular basement membrane with associated cellular interposition (silver stain). Original magnification ×400. Photo courtesy of Samih Nasr, Mayo Clinic, Rochester, MN.