SURYA V. SESHAN, M.D., New York-Presbyterian Hospital and Weill Medical College of Cornell University, New York, New York and LORRAINE C. RACUSEN, M.D., Johns Hopkins Hospital and Johns Hopkins School of Medicine, Baltimore, Maryland
This course is directed mainly to practicing pathologists, immunopathologists, fellows in renal pathology and immunopathology, and pathology residents. It will provide a systematic, clinicopathologic approach to the diagnosis of the most common primary and secondary glomerular diseases in the native kidney. The major objective is recognition of the basic patterns of glomerular injury, correlation with clinical findings, development of reasonable differential diagnoses (at the time of preliminary light microscopic examination) and arriving at the final diagnosis or impression after electron and immunofluoresence microscopic examination. The discussion also focuses on the application and utility of special stains, EM, IF and other methods. The prognostic value of the pathological findings, as well as their role in therapeutic decision making will be highlighted. This workshop also emphasizes: 1. Usefulness of clinical and laboratory data, 2. Proper handling and processing of renal biopsies/tissues for optimal utilization, 3. Frequently encountered problems with sampling and pitfalls in diagnosis, 4. Adequate review of normal architecture by light and electron microscopy, and 5. Essentials of an adequate renal biopsy report.
The WHO Classification of Glomerular Diseases which is based on combined morphology (LM, EM, IF) and clinical presentation will be used as a guide in the organization of the course. Cases will include both primary glomerular lesions and those occurring secondary to systemic diseases such as SLE, Diabetes mellitus, common viral infections (HBV, HCV, HIV), fibrillary and transplant glomerulopathies and amyloidosis. Up-to-date information regarding current pathogenetic mechanisms will be reviewed briefly. Transparencies of the various primary and secondary glomerular lesions including LM, EM, and IF will be prepared along with clinical summaries and mailed in advance to the participants for study. In addition, transparencies of LM, EM and IF pictures will be available on-site for review of cases for discussion. A syllabus containing the diagnosis and discussion of each case with pertinent references and parts of the lecture material will be distributed to all the participants at the time of the course.