PAS x40 - RCPA

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High power examination of H&E stains:• arteries– type (arcuate, interlobular or intralobular) and number– nature of thrombus or embolus– presence and severity of inflammation or necrosis– intimal thickness; if thickened, is there reduplication of elastin?– is the internal elastic lamina intact?– adventitia• arterioles– presence, location and severity of hyalinosis– presence and nature of thrombi• peritubular capillaries– normally inconspicuous, with only sparse leucocytes• veins– inflammation– congestion– thrombosis
H&E x2This is an H&E stain of a renalBx. Is any medulla present?Can you find glomeruli andarteries?
Page 3: Laboratory handling of renal Bx:•
Page 7 and 8: Our Medical Laboratory Scientist re
Page 9 and 10: Tissue for light microscopy:• des
Page 11 and 12: A paraffin embedded renal biopsy co
Page 13 and 14: Immunohistochemical stains:Native
Page 15 and 16: Examination of H&E stains:• on lo
Page 17 and 18: Medium power examination of H&E sta
Page 19: High power examination of H&E stain
Page 23 and 24: H&E x10This is a higher power view.
Page 25 and 26: H&E x10This is renal medulla. Most
Page 27 and 28: marksglomerulimarks arteriolesmarks
Page 29 and 30: H&E x40marksglomeruli/Bowman’s ca
Page 31 and 32: H&E x40marks arteriolesoutlines par
Page 33 and 34: tubular polevascular pole
Page 35 and 36: peritubular capllariesarteriolessma
Page 37 and 38: H&E x2H&E x10This is a biopsy from
Page 39 and 40: atrophic tubules in anarea of inter
Page 41 and 42: segmental sclerosisfocal mild incre
Page 43 and 44: the mesangium is expandedby amorpho
Page 45 and 46: PAS x10
Page 47 and 48: Bowman’s capsulemesangiumtubular
Page 49 and 50: PAS x40Glomerulus sectioned through
Page 51 and 52: segmental sclerosisfocal hyalinosis
Page 53 and 54: OVG x40 - interlobulararteryOVG x40
Page 55 and 56: Masson x40 -normal glomerulusMasson
Page 57 and 58: Masson x40Masson x40variations in s
Page 59 and 60: Masson x40: glomerulus with mesangi
Page 61 and 62: AgMT x40 - small arteryAgMT x40 - g
Page 63 and 64: AgMT x100Can you identify mesangial
Page 65 and 66: This biopsy is from someonewith the
Page 67 and 68: AgMT x100 -variations in staining f
Page 69 and 70: mesangial cell nucleismallsubepithe
Page 71 and 72:
AgMT x100:there is fuzzy materialor
Page 73 and 74:
Congo red stain showing theapple gr
Page 75 and 76:
Examination of immunohistochemical
Page 77 and 78:
IF IgG x40Normal kidney -immunofluo
Page 79 and 80:
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 and 132:
6. Other:• changes not considered
Page 133 and 134:
References:• Banff 07 Classificat
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PAS x40 - RCPA

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