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It works great for me, and I've done a lot of testing.
I disagree with the masteries too. Yes defense is nice, but as you say it, Karthus need a good mana regeneration, so why not taking Utility masterties ? You already got your wall and your harass to keep you safe.
Otherwise, your build is done nicely, that's sure.
Sorry, but that's a -1
I'll make the changes; agreed.
I give it +1, although I think you should mention that in late game people can sell the philosofer stone for zhonya's hourglas aswell. It's a good item , gives good HP and it can get you out of messy situations. Also the + 45 armor is pretty good considering you don't have much armor to begin with .