[Histonet] Hello fellow Histo's , 2 questions for you
carl.hobbs <@t> kcl.ac.uk
Thu Dec 24 17:08:55 CST 2009
Rene's comments are most appropriate.
When I was in Clinical Histopath ( a technician) at two different well-known London major Hospitals, it would be the technician who would be in the theatre when renal bxs were taken.
EG; the person who took the biopsy would pass the specimen to me to microscopically confirm that it was in fact renal cortex.
( several times it would be mesenteric fat with, sometimes, a tiny piece of cortex but no Gloms: a horrible situation to be in as I would have to ask for another bx: I never cared for the Bx
taker's opinion but I always felt very baad for the patient.)
However, one must appreciate that taking good/appropriate kidney bxs is a great skill, imho: the renal capsule ( Glisson's) could be hard to penetrate.
If the bx core was appropriate I would then sample the core for snap-freezing/pwax/TEM, depending upon the core ( with some advanced illness patients, one would have to work very hard to establish that the bx would be meaningful, diagnostically).
Yes, for TEM I would microscopically dissect out one or more glom. depending upon the bx.
No Pathologists were involved but all technicians were rigorously trained...( by experienced technicians;-)
I would do the equivilent for Quad muscle biopsies....and also for SI bxs for Coeliac's disease.
As a Technician, having to make such decisions was always very stressful for me as I was not trained to "distance " myself from the patient: I always empathised with the stress of the patient, particularly when the patient was a little kid or a kid/ adult who was very ill.
I can still recall them "whimpers" of distress.
Offsite bxs? Same applied. No Pathologist involved.
This never resulted in any problems, the 10 years I did this.
No comments in this email are relevant to current Practices and are reflections of my personal experience.
I wish all Histonetters a Happy Holidays/Xmas/Christmas!
And...success in the Christian New Year.
Most importantly, I wish the Initiators/Organisers/Maintainers of Histonet the same.
I am most grateful for this site.
It is an invaluable resource and yet still refreshingly simple , in this age of "bloated websites"
More information about the Histonet