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Archive: March 2021

Membranous Glomerulonephritis Stage II

Membranous Glomerulonephritis Stage II
This eyeSCANdy image shows acellular scanning EM from a biopsy with membranous glomerulonephritis, stage II. The extracted deposits previously resided in the dark spaces. The lighter GBM corresponds to “spikes” on silver stai.   Photo courtesy of Dr. Stephen Bonsib.  

Diagnose This (March 29, 2021)

Light Chain Deposition Disease
What would be your leading diagnosis given the glomerular changes in a patient with an abnormal SPEP? (Hint: Congo red and DNAJB9 stains are negative, powdery deposits by EM)     ​ ​   ​   ​ ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​   ​...

Episode 8: Going Deep

Keep Good Company, Stick to Your Knowledge, Never Be Afraid To Ask Questions, Making Time, How to Build A Reputation, Doing the Best You Can, Know Who Is In the Audience, Expanding the Differential Diagnosis, Knowing What Is Normal, Answer the Question, Knowing What You Know, Looking At Every Component, gestalt diagnosis, going deep, examining all the material, Lumping or Splitting, Focus, Using Therapy to Guide a Diagnosis, knowing the therapy, Severity of Change, principles of pathology, representativeness, arkana labs, renal path
Why should you go deep? Listen to Dr. Silva explain the importance of knowing what is normal, the pathogenesis, and the history in this episode of Principles of Pathology.  

Modified Gomori Trichrome (MGT)

Modified Gomori Trichrome (MGT)
Considering the clinical vignette from the prior week (elderly male with proximal muscle weakness). Staining the skeletal muscle biopsy in combination with Modified Gomori Trichrome (MGT) and oxidative stains can provide the neuropathologist with much information, including clues as to the ultrastructural abnormality of this myopathy. Using the images below, True or False:  The Modified Gomori Trichrome (MGT) staining in this skeletal muscle biopsy is definitive for mitochondria.   Frozen sections of skeletal muscle with Tubular Aggregate Myopathy (TAM) demonstrating two near by muscle fibers with round to ovoid eccentric and subsarcolemmal inclusion-type material with dense bright fuchsinophilic (red) staining...

Arkana Tot Shower

Today, we celebrated the arrival of Rowan by showering his mom with tons of diapers and all the baby gifts. Congrats Amber! P.S.- This shower was "out of this world".

Twitter Poll (March 17, 2021)

Minimal Change Disease, arkana laboratories, kidney pathology, renal pathology
Answer: Minimal Change Medullary angiitis is characterized by interstitial hemorrhage within the medulla combined with neutrophilic inflammation with associated karyorrhexis. This finding has been associated with all of the above diagnoses except for minimal change disease. Most often, it has been seen in association with systemic ANCA-associated vasculitis. For more information please see the following reference: References Hendricks AR, et al.  Renal medullary angiitis: A case series from a single institution. Hum Pathol.  2013 Apr;44(4):521-5.