[Histonet] GLOMERULI ADEQUACY

[Cartun, Richard]

We provide on-site assessment of the renal tissue obtained in Ultrasound, both at our main hospital and at our Children's hospital across the street.  I handle probably 95% of the biopsies; I have two pathology colleagues (MDs) that handle the other 5% when I am not here.  Occasionally, a resident or fellow (trained by me) will handle a biopsy after-hours.  We place the core(s) on a glass slide with a few drops of saline or RPMI and then examine it under a microscope using 4x and 10x objectives in Ultrasound.  We tell the interventional radiologist/PA or the nephrologist performing the procedure when the specimen is adequate.  We usually obtain adequate tissue with 2, 18-gauge needle cores in more than 90% of the procedures; sometimes we need to ask for a 3rd core.  On the other hand, I can make one core work when it's more than 2.0 cm long if there's cortex at both ends.  However, I don't recommend obtaining cores this long.  We have not had to repeat a biopsy over the last 25 years.

Richard

Richard W. Cartun, MS, PhD
Director, Histology & The Martin M. Berman, MD Immunopathology & Morphologic Proteomics Laboratory
Director, Biospecimen Collection Programs
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 972-1596
(860) 545-2204 Fax

-----Original Message-----
From: Melissa Likens via Histonet [mailto:histonet at lists.utsouthwestern.edu]
Sent: Wednesday, April 13, 2016 10:22 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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