Page 178 - ONLINE PROCEEDING BOOK WSAVA 2017
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An Urban Experience
WSVA7-0308
WSAVA RENAL STANDARDIZATION PROJECT
PATHOLOGICAL EVALUATION OF RENAL BIOPSIES: FROM THE CLINIC TO THE LAB
L. Aresu1
1Signor, Department of Comparative Biomedicine and Food Science, Legnaro, Italy
Since 2008, many vets from Europe and America have joined the International Veterinary Renal Pathology Service and the European Veterinary Renal Pathology Service. The two services have been created to provide information and instruments to improve health care
for dogs and cats affected by renal diseases. Also,
they supply a wide information network that helps clinicians to take decisions over pets, to send samples
to laboratories, to have shipment time shortened and
to have an ef cient schedule time that provides reports
in a short time. Speci c goals of this service were established a priori such as improvement of diagnostic process and outcomes of pets affected by renal diseases and the main purpose was to describe guidelines for histologic, ultrastructural and immuno uorescence examinations of renal tissue. When performing a renal biopsy few criteria should be encountered. First, the biopsy should be considered as a procedure to improve therapy and the biopsy itself should be done safely.
The tissue sample should be evaluated by expert
and specialized nephropathologists to get the most informative description using all the methods required to characterize the pathological changes. The required methods for renal biopsy evaluation include special staining protocols for light microscopic (LM) evaluation, as well as for transmission electron microscopic (TEM) and immuno uorescence evaluations (IF). Generally, two techniques for sampling are considered: 1) needle core biopsy, 2) wedge biopsy. Needle biopsies can
be obtained performing by laparoscopy, celiotomy, manual palpation and ultrasound-guided needle biopsy techniques. The latter is commonly performed and generally with satisfying results.
Nephropathology is a quite unique specialization in anatomic pathology and a complete set of analysis comprising LM, IF and TEM should be always considered. Samples for LM and TEM needs to be placed in formalin and glutaraldehyde, respectively. Whereas, samples for IF need to be stored in the transport solution (Michel’s transport media) and dispatched within 48 hours.
For LM, the renal tissue sections are usually thinner (2-3 μm thick) compared to sections obtained for other tissues in routine histopathology (5-6 μm thick). The method results important for assessment of glomerular
cellularity as well as for evaluation of glomerular basement membrane (GBM) through histochemical stains. Slides are alternatingly processed with at least 5 different histochemical stains: haematoxylin-eosin (H&E), periodic Acid-Schiff (PAS), Jones methenamine silver (JMS), Masson’s trichrome (TR) and Congo red stain (CR). The H&E-stained sections are useful for assessing cellular details such as the intrinsic cellular components of glomeruli, tubules, interstitium, and vessels, as well as extrinsic cells such as in ammatory cells. The PAS and JMS stains are indicated for assessing GBM thickening. PAS stain accentuates the tubular, Bowman’s capsule, and glomerular capillary wall basement membranes. Degenerating and atrophic tubules are visualized with PAS staining showing thickened basement membranes around the collapsed degenerated tubules. The JMS stain is useful for assessing external surface of the
GBM (subepithelial deposits), thickness, irregularity, small projections of GBM matrix such as spikes, holes and double contours. The TR stain stains collagen
and  brous connective tissues (e.g., interstitial  brosis, glomerulosclerosis) in blue. This staining is indicated to identify the presence of immune complexes.
For EM, as soon as the tissue is obtained from the kidney, it should be rapidly placed in the  xative. Afterwards, tissue is processed into plastic, trimmed,
cut a 1-μm section and stained with toluidine blue.
The sections required for the analysis are cut by ultramicrotome and collected on a copper grid and stained with lead citrate and uranyl acetate. Usually, one or 2 glomeruli are examined. At different magni cation, capillary loops, mesangial regions, tubular interstitial areas and vascular structures are examined. Some of the most important ultrastructural pathologic abnormalities are into the endothelial cells, GBM and visceral epithelial cells (i.e., podocytes). Additionally, EM evaluation is fundamental to detect electron-dense deposits of immune complexes (IC), which have different implications and identify different disease processes. The location
of IC is also very important whether in the mesangium or capillary walls (subepithelial, intramembranous, subendothelial, or associated with mesangial cell interpositioning).
For IF examination, fresh un xed renal specimens are embedded in OCT gel, snap-frozen in liquid nitrogen and stored at -80 0C. Then, sections from snap-frozen tissue are mounted. The common use of IF labelling
in veterinary nephropathology is to determine the phenotype of immune-deposits. The available antibodies are able to label canine IgG, IgM, IgA, C3 component of complement.
Recently, the World Small Animal Veterinary Association- Renal Standardization Study Group (WSAVA) has
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42ND WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS AND FECAVA 23RD EUROCONGRESS


































































































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