PAS x40 - RCPA

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The transplant biopsy report:• the recommended form is a descriptivenarrative followed by the Banff ’07 codesin parentheses• initial categorisation should be based solelyon pathological changes• integrate with clinical data as a second step• more than one diagnostic category may beused if appropriate
References:• Banff 07 Classification of Renal Allograft Pathology:Updates and Future DirectionsSolez et alAmerican Journal of Transplantation 2008; 8: 753–760• Non-Neoplastic Kidney Diseasesd’Agati, Jennette & Silva(AFIP Atlas of NonTumor Pathology #4)ARP Press 2005• Diagnostic Atlas of Renal PathologyFogo & KashgarianElsevier Saunders 2005• Theory and Practice of Histological Techniques,4 th EditionBancroft & StevensChurchill Livingstone 1996• Renal Pathology, 2 nd EditionDischeOxford Medical Publications 1995
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Laboratory handling of renal Bx:•
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Our Medical Laboratory Scientist re
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Tissue for light microscopy:• des
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A paraffin embedded renal biopsy co
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Immunohistochemical stains:Native
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Examination of H&E stains:• on lo
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Medium power examination of H&E sta
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High power examination of H&E stain
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H&E x2This is an H&E stain of a ren
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H&E x10This is a higher power view.
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H&E x10This is renal medulla. Most
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marksglomerulimarks arteriolesmarks
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H&E x40marksglomeruli/Bowman’s ca
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H&E x40marks arteriolesoutlines par
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tubular polevascular pole
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peritubular capllariesarteriolessma
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H&E x2H&E x10This is a biopsy from
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atrophic tubules in anarea of inter
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segmental sclerosisfocal mild incre
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the mesangium is expandedby amorpho
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PAS x10
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Bowman’s capsulemesangiumtubular
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PAS x40Glomerulus sectioned through
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segmental sclerosisfocal hyalinosis
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OVG x40 - interlobulararteryOVG x40
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Masson x40 -normal glomerulusMasson
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Masson x40Masson x40variations in s
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Masson x40: glomerulus with mesangi
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AgMT x40 - small arteryAgMT x40 - g
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AgMT x100Can you identify mesangial
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This biopsy is from someonewith the
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AgMT x100 -variations in staining f
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mesangial cell nucleismallsubepithe
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AgMT x100:there is fuzzy materialor
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Congo red stain showing theapple gr
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Examination of immunohistochemical
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IF IgG x40Normal kidney -immunofluo
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IF fibrin x40Normal kidney -immunof
Page 81 and 82: IF C1q x40Normal kidney -immunofluo
Page 83 and 84: IP IgA x40Normal kidney - immunoper
Page 85 and 86: IP IgG x40Normal kidney - immunoper
Page 87 and 88: IP IgM x40Normal kidney - immunoper
Page 89 and 90: IP C3 x10
Page 91 and 92: IP C1q x40IP C1q x10Normal kidney -
Page 93 and 94: IP kappa x40IP lambda x40Immunopero
Page 95 and 96: IP C4d x40Immunoperoxidase for C4d
Page 97 and 98: IP SV40 x40 biopsy BImmunoperoxidas
Page 99 and 100: Electron microscopy:• a piece of
Page 101 and 102: Toluidine blue x40Toluidine blue x2
Page 103 and 104: Assessment of the glomerulus in ele
Page 105 and 106: This is a low power electron microg
Page 107 and 108: This glomerulus is normocellular, w
Page 109 and 110: mesangial matrixepithelial cellfoot
Page 111 and 112: The Banff Classification of Renal A
Page 113 and 114: Specimen adequacy(a necessary prere
Page 115 and 116: Quantitative criteria for mononucle
Page 117 and 118: Quantitative criteria for arteriola
Page 119 and 120: Quantitative criteria for peritubul
Page 121 and 122: Quantitative criteria for interstit
Page 123 and 124: Quantitative criteria for fibrous i
Page 125 and 126: C4d scoring :% biopsy area(cortex a
Page 127 and 128: 2. Antibody-mediated changes:may co
Page 129 and 130: 4. T-cell-mediated rejection (TCMR)
Page 131: 6. Other:• changes not considered
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PAS x40 - RCPA

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