scholarly journals The role of electron microscopy for the diagnosis of glomerulopathies

2004 ◽  
Vol 122 (3) ◽  
pp. 104-109 ◽  
Author(s):  
Angelo Sementilli ◽  
Luiz Antonio Moura ◽  
Marcello Fabiano Franco
Keyword(s):  
Electron Microscopy ◽  
Light Microscopy ◽  
Laboratory Data ◽  
Final Diagnosis ◽  
Glomerular Diseases ◽  
Financial Pressure ◽  
Renal Biopsies ◽  
Morphological Diagnosis ◽  
Selection Of

CONTEXT: Electron microscopy has been used for the morphological diagnosis of glomerular diseases for more than three decades and its value has been widely emphasized. However, recent reports have analyzed the routine use of electron microscopy critically. Its use in other areas of diagnosis such as tumor diseases has declined considerably; in addition, in view of the unavoidable financial pressure for the reduction of costs due to investigations and diagnostic routines, the selection of cases for electron microscopy has been quite rigorous. OBJECTIVE: To identify the glomerular diseases that depend on electron microscopy for a final diagnosis, by means of reviewing renal biopsies performed over a 12-year period. DESIGN: Prospective SETTING: Hospital Ana Costa, Hospital Guilherme Álvaro and Serviço de Anatomia Patológica de Santos, Santos, São Paulo, Brazil. PARTICIPANTS: 200 consecutive renal biopsies obtained from private hospitals and the teaching hospital from 1979 to 1991 were studied. MAIN MEASUREMENTS: All cases were analyzed via light microscopy, immunofluorescence and electron microscopy. The diagnosis was first made via light microscopy plus immunofluorescence and then via electron microscopy. RESULTS: Electron microscopy was diagnostic or essential for diagnosis in 10.0% of the cases, corresponding to 3.4% of primary glomerulopathies and 100% of hereditary glomerulopathies. Electron microscopy was contributory (useful) to the diagnosis in 5.5% of the cases, confirming the preliminary diagnosis formulated on the basis of clinical and laboratory data and light microscopy plus immunofluorescence findings. We obtained a 7.5% rate of discordant immunofluorescence, which was considered as such when negative immunofluorescence findings were not confirmed by electron microscopy. The final diagnosis with the use of light microscopy plus immunofluorescence alone was 77.0%. CONCLUSIONS: It was possible to diagnose with certainty a great percentage of glomerulopathies (82.5-90% of the cases) based on the light microscopy and immunofluorescence findings alone. Electron microscopy was essential for the diagnosis of hereditary nephropathies.

scholarly journals A reevaluation of routine electron microscopy in the examination of native renal biopsies.

1997 ◽  
Vol 8 (1) ◽  
pp. 70-76
Author(s):  
M Haas
Keyword(s):  
Electron Microscopy ◽  
Lupus Nephritis ◽  
Light Microscopy ◽  
Final Diagnosis ◽  
Preliminary Diagnosis ◽  
Ultrastructural Studies ◽  
Collapsing Glomerulopathy ◽  
Postinfectious Glomerulonephritis ◽  
Renal Biopsies ◽  
Made In

Electron microscopy is routinely utilized in most centers in the evaluation of native renal biopsies. Several studies, primarily from the 1960s and early 1970s, provide justification for its use. Conducted by Siegel et al. (1), the largest study evaluated 213 consecutive renal biopsies and found that electron microscopy was needed for a correct diagnosis in 11%, as well as for confirmation or additional information in another 36%. However, nearly all of these studies were conducted before the use of immunofluorescence in renal biopsy diagnosis became widespread and before several new glomerular diseases and variants were described. In light of this situation and the expense of the procedure, the routine use of electron microscopy in native renal biopsies also examined by immunofluorescence and routine light microscopy was reevaluated. From January 1996 to June 1996, 288 native renal biopsies were received, and all were evaluated by the same pathologist. Of those, 233 met criteria for inclusion in this study, which were > or = 5 glomeruli for light microscopy, > or = 2 for immunofluorescence, and > or = 1 for electron microscopy, not including globally scarred glomeruli. Light microscopy (hematoxylin and eosin, periodic acid-Schiff stains) and immunofluorescence--for immunoglobulin (Ig) G, IgA, IgM, C3, C1q, fibrinogen; kappa/lambda when needed--were evaluated on each biopsy within 48 h of receipt, and a preliminary diagnosis was recorded if possible. Electron microscopy was then performed, and a final diagnosis was made. In 50 cases (21%), electron microscopy was needed to make the final diagnosis; in two of these cases, the preliminary diagnosis was incorrect, and in 48, a firm preliminary diagnosis could not be made. In the other cases, the preliminary diagnosis was correct, but in 48 (21%), ultrastructural study was felt to provide important confirmatory data, and in eight cases (3%), an additional, unrelated diagnosis was supported by the ultrastructural findings. Diagnoses most frequently requiring electron microscopy included minimal change nephropathy, early diabetic nephropathy, membranous lupus nephritis, membranoproliferative glomerulonephritis, postinfectious glomerulonephritis, thin basement membrane nephropathy (or exclusion of this in cases of otherwise unexplained hematuria), and human immunodeficiency virus-associated nephropathy (or exclusion of it in cases of collapsing glomerulopathy). Common diagnoses usually not requiring electron microscopy included IgA nephropathy, diffuse proliferative lupus nephritis, focal segmental glomerulosclerosis (not collapsing glomerulopathy variant), pauci-immune crescentic glomerulonephritis, acute interstitial nephritis, and amyloid nephropathy. This study confirms that, as was the case 20 to 30 yr ago, electron microscopy provides useful diagnostic information in nearly half of native renal biopsies. If electron microscopy cannot be performed routinely on all such biopsies, it is recommended that tissue for ultrastructural studies be set aside in each case.

scholarly journals The role of electron microscopy in kidney lesions: A review of its diagnostic importance

2013 ◽  
Vol 3 (5) ◽  
pp. 411-415
Author(s):  
AD Pant ◽  
K Solez
Keyword(s):  
Electron Microscopy ◽  
Light Microscopy ◽  
Renal Biopsy ◽  
Renal Pathology ◽  
Malignant Diseases ◽  
The World ◽  
Kidney Lesions ◽  
Diagnostic Importance

Electron microscopy is a technology which was at one time widely used for renal as well as non-renal benign and malignant diseases, but its use has been rapidly declining as hospitals all over the world cut down on expenses. This leaves the renal pathologist with only light microscopy and immunofl uorescence at his disposal to diagnose diseases. Few studies have stated the importance of electron microscopy in routine renal biopsy reporting. We look at different cases where electron microscopy has been helpful in diagnosis and review the literature to assess the role this investigative modality still has to play in modern renal pathology. Journal of Pathology of Nepal (2013) Vol. 3, No.1, Issue 5, 411-415 DOI: http://dx.doi.org/10.3126/jpn.v3i5.7871

Electron Microscopy in the Diagnosis of Liposarcoma and Fibrosarcoma of the Larynx

1979 ◽  
Vol 88 (6) ◽  
pp. 867-871 ◽  
Author(s):  
David N. Tobey ◽  
Roger F. Wheelis ◽  
C. Thomas Yarington
Keyword(s):  
Electron Microscopy ◽  
Light Microscopy ◽  
Accurate Determination ◽  
Final Diagnosis ◽  
Primary Lesion ◽  
Low Grade ◽  
Pathologic Evaluation ◽  
First Case ◽  
Per Se

Electron microscopy (EM) was useful in establishing the final diagnosis in specific instances of liposarcoma and fibrosarcoma of the larynx. In the first case light microscopy revealed cells that met the histologic criteria of a low grade liposarcoma; EM revealed cells that displayed a varied ultrastructural differentiation; thus the tumor was classified as a mixed mesenchymal tumor rather than liposarcoma per se. In the second case, pathologic evaluation indicated a grade 2 fibrosarcoma. EM revealed malignant mesenchymal cells that closely recapitulated normal fibroblasts (no epithelial differentiation was present). This kind of information enables more accurate determination of the source of the primary lesion than results of light microscopy alone.

Sclerosing Glomerulonephritis

1975 ◽  
Vol 33 ◽  
pp. 408-409
Author(s):  
A. Mandal ◽  
K. Chrysant ◽  
J. Nordquist ◽  
S. Kraikitpanitch ◽  
D. Xoung ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Renal Failure ◽  
Retrospective Study ◽  
Light Microscopy ◽  
Membranous Glomerulonephritis ◽  
Chronic Glomerulonephritis ◽  
Previous Diagnosis ◽  
Renal Biopsies ◽  
End Stage ◽  
Made In

A small but undefined percentage of adults with idiopathic proteinuria, microscopic hematuria and hypertension with partial or no response to corticosteroid or immunosuppressive therapy, progress slowly to renal failure. Histological diagnosis of membranous, membranoproliferative or chronic glomerulonephritis were made in these patients. Retrospective reevaluation of renal pathology in such patients has resulted in the emergence of a new clinicopathological entity. We are reporting a retrospective study of renal biopsies using light microscopy (LM) and electron microscopy (EM) from six patients with previous diagnosis of proliferative glomerulonephritis (2 patients), membranous glomerulonephritis (2 patients), nephrosclerosis (1 patient) and end stage kidney (1 patient). These patients were aged between l6 and 51 years, four males and two females. They had initial average 24 hour proteinuria of 1.3 gm (range 0.5-3.4 gm) and blood urea nitrogen of 24 mgm percent (range 12-32 mgm percent).

scholarly journals Formaldehyde as a Fixative for Light and Electron Microscopy

2000 ◽  
Vol 8 (5) ◽  
pp. 30-31
Author(s):  
Freida L. Carson
Keyword(s):  
Electron Microscopy ◽  
Light Microscopy ◽  
Light And Electron Microscopy ◽  
Parallel Study ◽  
Electron Microscopic ◽  
Dual Purpose ◽  
Ultrastructural Morphology ◽  
The World ◽  
Selection Of

Since Blum discovered its hardening properties in 1893, formaldehyde has become the most widely used fixative in the world for specimens to be examined by light microscopy. However, since most commercial preparations of formaldehyde contain methanol, a protein precipitant, formaldehyde has been considered an unsatisfactory fixative for tissues to be examined by electron microscopy. In 1973, Carson et al., described a parallel study comparing the electron microscopic results of fixation with paraformaidehyde vs. formaldehyde. They found that there was no difference in the preservation of ultrastructural morphology provided that the buffer systems were identical. In 1976, McDowell and Trump described a fixative combining commercial formaldehyde and glutaraldehyde (4CF-1G). Both of these fixatives are dual purpose fixatives and preclude the selection of tissue for electron microscopy prior to fixation. They can both be prepared in large quantities and used for routine surgical specimens. The fixative containing formaldehyde alone does not need to be refrigerated and is stable for months; whereas, the formaldehyde-glutaraldehyde mixture should be refrigerated.

scholarly journals Role of Electron Microscopy in Early Detection of Altered Epithelium During Experimental Oral Carcinogenesis

2019 ◽  
Vol 25 (6) ◽  
pp. 1367-1375
Author(s):  
Sharada Sawant ◽  
Harsh Dongre ◽  
Deepak Kanojia ◽  
Sayli Jamghare ◽  
Anita Borges ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Early Detection ◽  
Light Microscopy ◽  
Cancer Progression ◽  
High Resolution Electron Microscopy ◽  
Cellular Adhesion ◽  
Significant Loss ◽  
Resolution Electron ◽  
Rat Tongue

AbstractEarly detection of altered epithelium can help in controlling the further progression by timely intervention. Alterations in cellular adhesion are one of the hallmarks of cancer progression, which can be detected at the intracellular level using high-resolution electron microscopy. This study aimed to evaluate the role of electron microscopy in the establishment of ultrastructural markers for early detection of altered epithelium using tissues from 4-Nitroquinoline-1-Oxide (4NQO) induced rat tongue carcinogenesis. Our previous study using light microscopy displayed no histopathological alterations in 4NQO treated tissues until 40 days of treatment, while dysplasia, papilloma and carcinoma were detected at 80/120, 160 and 200 days, respectively. However, electron microscopy detected alterations such as detachment of desmosomes from cell membranes and their clustering in the cytoplasm, increased tonofilaments, keratohyaline granules and thickened corneum in 40 days treated corresponding tissues. These alterations are apparent with hyperkeratosis/hyperplasia but remained undetected using light microscopy. Further, in dysplasia, papilloma and carcinoma, gradual and significant loss of desmosomes, leading to the significant widening of intercellular spaces, was observed using iTEM software. These parameters may serve as indicators for progression of oral cancer. Our results highlight the importance of electron microscopy in the early detection of subcellular changes in the altered epithelium.

Focal Glomerular Immune Complex Deposition: Possible Role of Periglomerular Fibrosis/Atubular Glomeruli

2009 ◽  
Vol 133 (2) ◽  
pp. 283-288 ◽  
Author(s):  
Anjali A. Satoskar ◽  
Edward Calomeni ◽  
Cherri Bott ◽  
Gyongyi M. Nadasdy ◽  
Tibor Nadasdy
Keyword(s):  
Electron Microscopy ◽  
Immune Complex ◽  
Glomerular Sclerosis ◽  
Immune Complex Deposition ◽  
Atubular Glomeruli ◽  
Renal Biopsies ◽  
Transplant Kidney ◽  
Complex Deposition ◽  
Microscopy Examination

Abstract Context.—Consensus exists among renal pathologists that, in biopsies with immune complex glomerulonephritis, even a single glomerulus with open capillary loops may be sufficient for immunofluorescence and/or electron microscopy evaluation because immune complex deposition is a diffuse phenomenon. However, we have encountered renal biopsies with focal absence of immune complexes in glomeruli on either immunofluorescence or electron microscopy examination despite presence of open glomerular capillary loops. Objective.—To evaluate renal biopsies with focal immune complex deposition and look for any subtle or unusual morphologic changes in the glomeruli (and in the biopsy in general). Design.—Native and transplant renal biopsies were reviewed. All biopsies had been triaged and processed according to our routine protocol for light microscopy, immunofluorescence, and electron microscopy examination. Results.—Of 2018 renal biopsies from December 2005 to December 2007, we found 10 such biopsies; 5 native and 5 transplant kidney biopsies. We found that the glomeruli with absent immune complex deposits had periglomerular fibrosis with open, albeit, wrinkled appearing capillary loops but no glomerular sclerosis. Conclusions.—We hypothesize that these histologic features are indicative of nonfunctional glomeruli and may be associated with disconnection between the Bowman capsule and proximal tubule (atubular glomeruli). These glomeruli may not have effective filtration, despite some degree of circulation through the open capillary loops, and therefore are unable to accumulate immune complex deposits. If biopsies are small and only such glomeruli are available for immunofluorescence or electron microscopy examination, the absence of immune complex deposition in them should be evaluated carefully.

Clinicopathological analysis of nonfunctioning pituitary adenomas in patients younger than 25 years of age

2012 ◽  
Vol 9 (5) ◽  
pp. 511-516 ◽  
Author(s):  
Mitsuo Yamaguchi-Okada ◽  
Naoko Inoshita ◽  
Hiroshi Nishioka ◽  
Noriaki Fukuhara ◽  
Shozo Yamada
Keyword(s):  
Electron Microscopy ◽  
Light Microscopy ◽  
Pituitary Adenomas ◽  
Clinical Symptoms ◽  
Young Patients ◽  
Immunohistochemical Analysis ◽  
Nonfunctioning Pituitary Adenomas ◽  
Therapeutic Procedures ◽  
Morphological Diagnosis ◽  
Subtype 3

Object The authors evaluated the pathological and clinical characteristics of young patients with clinically nonfunctioning pituitary adenomas (NFPAs). Methods Twenty-one patients (13 males and 8 females) with NFPAs who were 25 years of age or younger (mean 20 years, range 13–25 years) were retrospectively investigated. The following factors were examined: results of conventional light microscopy, immunohistochemistry, and electron microscopy; clinical symptoms; tumor size and invasion on MRI; and clinical course after therapeutic procedures such as surgery and adjuvant radiotherapy. Results Two major significant findings in young patients with NFPAs were noted. First, silent subtype 3 adenomas were common, whereas silent gonadotroph adenomas were rare. Second, silent subtype 3 adenomas in young patients tended to be clinically and radiologically aggressive. Conclusions To correct the morphological diagnosis, NFPAs in young patients should be examined by immunohistochemical analysis and electron microscopy, as well as by light microscopy. The authors' results provide information that will be useful when making decisions regarding the treatment of young patients with NFPAs.

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