The tubule in the center of the photo shows intraepithelial mononuclear cell infiltration.  That is tubulitis. Because it is longitudinal section of that tubule, the tubulitis should be graded based on X mononuclear cells/10 tubular cells.  There are more than 20 tubular epithelial cells in that tubule with 11 or 12 infiltrating mononuclear cells. The final grading would be t2 (5-6/10 tubular cells, moderate tubulitis).  The other tubule close to the right upper corner demonstrates 4 infiltrating mononuclear cells. It should be graded as t1. If the interstitium is more than 25% inflamed (i2), these findings will be enough to be diagnosed of acute T-cell-mediated rejection, Banff type 1A (i2, t2).

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明显的肾小管炎（粗估分级t3，依据：中央那个肾小管的断面上，浸润炎细胞数＞10个，不知在肾穿全部标本中是灶状or多灶状？），应该为急性细胞性排斥反应。

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