PAS x40 - RCPA

Medium power examination of H&E stains:• glomeruli– count the number present, including globally sclerosed glomeruli– assess size (normal around 200µ) and overall cellularity– look for crescents (≥3 layers of epithelial cells at the periphery ofthe tuft) or necrosis– look for segmental lesions• tubules– how extensive is any atrophy?– are there casts (hyaline, granular, cellular, red cell, haem)?– are there any inflammatory cells (neutrophils, lymphocytes,macrophages)– are there degenerative and regenerative changes?• interstitium– is there oedema?– is there a cellular infiltrate?– is there fibrosis?• arteries, arterioles, peritubular capillaries and veins– arterioles are usually ≤100µ in diameter– look for thrombosis, emboli, inflammation, necrosis, fibrosis