[Histonet] GLOMERULI ADEQUACY

[Normington Lacy]

We have our histology technicians attend all native and transplant renal biopsy procedures.  Our institution has stereo scopes (dissecting scope) located in ultrasound, transplant clinic and an additional one on a mobile cart for cases that might occur in Pediatric sedation, ICU, or bedside biopsies.  The core biopsy is handed to the histology technician who then looks under the scope to look for glomeruli.  Some of our clinicians like an approximate glomeruli count, although, most just want to know if they have cortical tissue.  In each of our reports we place the following comment per CAP regulations regarding adequacy (see below).  If a sample is difficult to determine adequacy, we always leave it up to the Nephrologist discretion.  We have a lead technician in the renal laboratory.  This individual trains all new employees on adequacy assessment.  Modern Pathology has an excellent photo of the difference between cortex and medullary tissue.  Search google images for dissecting scope renal biopsy.
 
____	At the time of sample collection, this sample visibly contains cortical tissue and is Satisfactory for Evaluation.
____	At the time of sample collection, cortical tissue is not identifiable and is Unsatisfactory for Evaluation.

Lacy

-----Original Message-----
From: Melissa Likens via Histonet [mailto:histonet at lists.utsouthwestern.edu] 
Sent: Wednesday, April 13, 2016 9:22 AM
To: 'histonet at lists.utsouthwestern.edu'
Subject: [Histonet] GLOMERULI ADEQUACY

I have a question about how other institutions handle microscopic evaluation of glomeruli adequacy in renal specimens?  Specifically, who at you looks at the cores to determine if glomeruli are present before submitting specimens for further testing?  Do the pathologists look at them? Radiologists performing the cores?  Other staff?
Also, any links or recommendations for training for evaluating renal biopsies for glomeruli would be appreciated.
Thanks, Melissa
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