Mr. Douglas, a 55-year-old male, has a history of end-stage renal disease secondary to chronic glomerulonephritis. Five years ago, he underwent a successful renal transplant. However, he has recently experienced a decline in renal function, manifesting as fatigue, shortness of breath, swelling in his legs and ankles, decreased urine output, elevated blood pressure, nausea, and vomiting. Physical examination reveals elevated blood pressure, periorbital edema, decreased breath sounds, peripheral edema, and tenderness over the transplanted kidney. Laboratory tests show elevated serum creatinine, blood urea nitrogen, and decreased estimated glomerular filtration rate. Electrolyte abnormalities, including hyperkalemia and hyponatremia, are also present. Additionally, anemia and elevated inflammatory markers such as C-reactive protein and erythrocyte sedimentation rate are noted. Based on these findings, a diagnosis of chronic renal transplant rejection is made. A kidney biopsy is also ordered. Which of the following best describes the histological picture seen in chronic renal transplant rejection?
