General Information
The Yale Renal Pathology and Electron Microscopy Laboratory is a nationally recognized center for diagnostic renal pathology and electron microscopy. It provides the most effective methodologies available for light microscopic, ultrastructural and immunological diagnosis of kidney biopsies and surgical pathology specimen. These include transmission electron microscopy, immunohistochemistry and standard and confocal immunofluorescence microscopy. There is special emphasis on the diagnosis of glomerular, tubulointerstitial and vascular kidney diseases, as well as evaluation of transplant kidney biopsies. Electron microscopy is further of value in the diagnosis of ciliary abnormalities, metabolic disorders, microbial identification, and tumor diagnosis. As one of the few clinical electron microscopy services with digital imaging capability in the nation, the Yale Renal Pathology Laboratory is well positioned to serve a wide geographic area with rapid turnaround time combined with expert consultative services.
Highlights
- Provides high quality electron micrographs/digital images for analysis of ultrastructural pathologic changes in organ tissue.
- Maintains the highest level of diagnostic accuracy coupled with rapid turnaround time for renal diseases, ciliary abnormalities, metabolic disorders, microbial identification, and tumor diagnosis.
- Assists in developing new programs, such as a comprehensive program for diagnosis of immunologic diseases and the center for excellence in organ transplantation.
People
Dr. Gilbert Moeckel is Director and Dr. Jan Czyzyk is an Associate Research Scientist in Pathology. Both Drs Moeckel and Czyzyk are responsible for the daily diagnostic work up of kidney biopsies and surgical pathology specimen for Electron Microscopic evaluation. Dr. Michael Kashgarian is the Emeritus Director of the laboratory and an active consultant on the clinical service. The laboratory is staffed by two full-time electron microscopists: Margaret Ianniello, Manager, and Judith Mitnick Ph.D. Administrative support is provided by Pamela Clark.
Facility
The laboratory is located in the Medical School, Lauder Hall LB20. Facilities include a cutting room with two Reichert Ultramicrotomes - Ultracut E and Ultracut S. An embedding area includes the Reichert Lynx Tissue Processor and the Leica EMStain automatic stainer. The Zeiss LIBRA 120 Electron Microscope is used to scan the specimens. Images are digitized from the electron microscope using the Advanced Microscopy Techniques (AMT) CCD Camera system and software.
Frequently Asked Questions
for physicians:
What are the indications for a renal biopsy?
Although patients with all varieties of renal parenchymal disease have undergone renal biopsy, the biopsy is of greatest value in patients with large amounts of proteinuria, patients with systemic disease that nvolve the kidneys, certain patients with acute renal failure, and patients with an active urinary sediment. Important clinical information such as serum creatinine, serologic studies, and the degree of proteinuria are useful in assisting the interpretation of the renal biopsy.
Can the biopsy assess the risk of progression and the potential for response to therapy?
The renal biopsy provides significant information relative to the risk of progression by examining the degree of tubulointerstitial scarring. The potential to respond to therapy is generally based on the presence or absence of acute inflammatory changes in the glomerulus and in the tubulointerstitial compartment.
What clinical information will assist in the evaluation of the renal biopsy?
Important clinical information such as serum creatinine, serological studies for hepatitis and lupus, and the degree of proteinuria are generally useful in assisting in the interpretation of the renal biopsy.
Does a needle biopsy provide an adequate sampling?
It is generally felt that needle biopsy of the kidney gives a sufficient sampling for most processes that involve the glomerular or tubulointerstitial compartments.
What types of infectious diseases are identified by electron microscopy?
Electron microscopy has proven useful in the diagnosis of a wide range of viral diseases and in the diagnosis of unusual infectious agents such as spirochetes, microsporidia, and protozoa mechanisms.
for patients:
Why do I need a renal biopsy?
While your doctor may be able to tell you that you have a disease, which affects your kidneys, laboratory tests and physical examination are generally insufficient to give the accurate diagnosis your doctor needs to plan your therapy and management. The exact kidney disease is often only correctly identified through a tissue diagnosis, which the biopsy provides.
What are the potential complications of a needle biopsy?
The technique of a renal biopsy has been improved so that complications are very uncommon. It is relatively rare to have a serious complication, although it is not uncommon to have blood in the urine following a biopsy.
Consult Services
Complete electron microscopy and renal biopsy consultation services are
available to departments and physicians within YNHH, as well as outside
hospitals and groups.
More information is available by contacting:
Renal Pathology and Electron Microscopy Laboratory
Department of Pathology
Yale University School of Medicine
P.O. Box 208023
310 Cedar Street, LH B20
New Haven, CT 06520-8023
Phone: (203) 785-2750
Fax: (203) 785-3348