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 sc
 ope 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@lists.utsouthwestern.edu] 
Sent: Wednesday, April 13, 2016 9:22 AM
To: 'histonet@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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