A 35-year-old man of African ancestry has nephrotic-range proteinuria that responds poorly to steroids. The biopsy shown has sclerosis and hyalinosis affecting only a segment of some glomeruli, while others look normal. Which lesion is this, and what would electron microscopy show?
A) Focal segmental glomerulosclerosis with diffuse foot-process effacement
B) Membranous nephropathy with subepithelial spikes
C) Minimal change disease with normal glomeruli
D) Diffuse proliferative glomerulonephritis
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September 5, 2026 356
