Renal Ultrastructure Atlas

1. Renal Ultrastructure Atlas Wm. J. Hunter M. D.

2. How to Use This Atlas • These photos are meant to supplement your Jungueire text-atlas and Robbins by giving some different views. • Generally I put an unlabeled photo on one page and the labeled view on the next. Try to identify the cells and structures first before looking at the labels. • This atlas is posted in blackboard-- the resolution on screen is much better than in this handout. • Please contact me if you have any questions.

3. Normal gomerulus

4. Epithelial cell(podocyte) parietal cell prox. tubule Endothelial cell mesangial cell capillary lumen

5. Diagrammatic view of low power EM

6. Low power view of Normal glomerulus

7. Low power view of Normal glomerulus Endothelial cell nucleus Capillary lumen Mesangial cell Endothelial cell RBC Epithelial cell (podocyte) Bowman’s space (urinary Space) Capillary lumen

8. Medium power EM of a capillary loop

9. Medium power EM of a capillary loop Mesangial cell cytoplasm Mesangial matrix Endothelial cell nucleus Capillary lumen Urinary space Endothelial cell fenestrations Epithelial cell (podocyte) Parietal layer of bowman’s capsule Foot processes

10. Another capillary loop

11. Another capillary loop Mesangial cell Capillary lumen RBC Urinary space Epithelial cell (podacyte)

12. The glomerular capillary basement membrane

13. The glomerular capillary basement membrane Capillary lumen Endothelial cell Foot process BM Epithelial cell Urinary space

14. Close up of BM

15. Close up of Basement Membrane Epithelial cell Urinary space Slit membrane Foot process Lamina rara externa Lamina densa BM Lamina rara interna Endothelial cell fenestration Capillary lumen

16. microvilli Proximal tubules- note hard to see cell borders

17. Low power of proximal tubule

18. Low power of proximal tubule Tubular BM Brush border Interdigitated Lateral process

19. Distal tubule

20. Distal tubule lumen Plasma cell Short villi Interstitial cell

21. Collecting tubule/duct

22. Collecting tubule/duct lumen

23. Classic Glomerular Disorders • Please refer to these cases as we discuss them in class • Think about the classic picture on light microscopy, immunofluorescence and electron microscopy and • Explain the pathophysiology of the diseases

24. Acute proliferative GN (post strep)

25. Acute proliferative GN (post strep)

26. Hypercellular glomeruli Increased # of cells Normal glomerulus

27. IF showing “lumpy-bumpy” pattern

28. Minimal change disease

29. Minimal change disease

30. Minimal change disease “normal” glomerulus by light microscopy

31. Minimal change disease

32. Minimal change disease

33. Membranous nephropathy thickened BM

34. Membranous GN

35. Membranous GN

36. Membranous GN

37. Membranous GN

38. Membranous GN

39. Diffuse proliferative lupus GN (WHO class IV) all glomeruli involved Endothelial, epithelial, & mesangial proliferation, thrombosis of Capillaries (note few capillary lumens seen)

40. IF in lupus nephritis anti-IgG

41. Proliferative lupus nephritis wire loop--subendothelial deposit

42. Lupus nephritis- Wire loops

43. Lupus nephritis- Wire loops

44. Lupus nephritis- Wire loops

45. Lupus nephritis- Wire loops

46. Lupus nephritis- Wire loops

47. Lupus nephritis- Wire loops

48. Lupus nephritis- Wire loops