Review Question - QID 212598

A 27-year-old woman presents to the emergency department for fever and generalized malaise. Her symptoms began approximately 3 days ago, when she noticed pain with urination and mild blood in her urine. Earlier this morning she experienced chills, flank pain, and mild nausea. Approximately 1 month ago she had the "flu" that was rhinovirus positive and was treated with supportive management. She has a past medical history of asthma. She is currently sexually active and uses contraception inconsistently. She occasionally drinks alcohol and denies illicit drug use. Family history is significant for her mother having systemic lupus erythematosus. Her temperature is 101°F (38.3°C), blood pressure is 125/87 mmHg, pulse is 101/min, and respirations are 18/min. On physical examination, she appears uncomfortable. There is left-sided flank, suprapubic, and costovertebral angle tenderness. Urine studies are obtained and a urinalysis is demonstrated below:

Color: Amber
pH: 6.8
Leukocyte: Positive
Protein: Trace
Glucose: Negative
Ketones: Negative
Blood: Positive
Nitrite: Positive
Leukocyte esterase: Positive
Specific gravity: 1.015

If a renal biopsy is performed in this patient, which of the following would most likely be found on pathology?