1 / 23

1. Count all glomeruli, determine the number of sclerotic glomeruli

1. Count all glomeruli, determine the number of sclerotic glomeruli. Normal renal cortex. H&E. Normal Glomerulus. Normal Glomerulus. GLOBAL SCLEROSIS (PAS). Glomerular obsolescence (count as sclerotic). SEGMENTAL SCLEROSIS (PAS). Should be rare in Loop biopsies.

aysha
Download Presentation

1. Count all glomeruli, determine the number of sclerotic glomeruli

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. 1. Count all glomeruli, determine the number of sclerotic glomeruli

  2. Normal renal cortex. H&E

  3. Normal Glomerulus

  4. Normal Glomerulus

  5. GLOBAL SCLEROSIS (PAS)

  6. Glomerular obsolescence (count as sclerotic)

  7. SEGMENTAL SCLEROSIS (PAS) Should be rare in Loop biopsies

  8. Mesangial expansion, hypercellularity You can note it but not important if mild

  9. Nodular mesangial sclerosis (PAS) Means that the donor was diabetic. Should be noted, very rarely occurs

  10. Glomerular capillary microthrombi (Trichrome) Glomeruli fibrin thrombi are common in brain trauma; they indicate donor DIC. Report it, but these thrombi go away quickly in the recipient

  11. 2. Estimate degree of interstitial fibrosis • Mild: up to 25% of cortex (do not consider medulla) • Moderate 25-50% of cortex • Severe: Over 50% • Note inflammation (usually mild and patchy in fibrotic areas), if present

  12. Severe interstitial fibrosis (right side is intact)

  13. This entire area is fibrotic

  14. 3. Examine vasculature • Note arteriolar hyalin • Note intimal thickening • Mild: if less than thickness of the media • Moderate: Thicker than the media • Severe: More than twice the thickness of the media with luminal narrowing • Note severe obliterative intimal thickening (usually kidney will be discarded • Note arterial/arteriolar thrombi – Thrombotic microangiopathy (TMA) – rare in donors but bad

  15. Normal arteriole

  16. Severe arteriolar hyalin

  17. Normal intrarenal artery

  18. Intimal thickening

  19. Thrombotic microangiopathy with luminalobliteration

  20. TMA with obliterated lumen and fragmented RBCs

  21. TMA with severe mucoid thickening of a small artery

  22. Conclusions • Do not give diagnosis • Be descriptive • Acute tubular necrosis (ATN) is common in loop biopsies. If severe, you can comment on it (prominently thin tubular epithelium, lots of debris in tubular lumina) but it is reversible and if not striking do not mention it

More Related