Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to...

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Renal Ultrastructure Atlas Wm. J. Hunter M. D.

Transcript of Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to...

Page 1: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Renal Ultrastructure Atlas

Wm. J. Hunter M. D.

Page 2: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

How to Use This Atlas

• These photos are meant to supplement your Jungueire text-atlas and Robbins by giving some different views.

• Generally I put an unlabeled photo on one page and the labeled view on the next. Try to identify the cells and structures first before looking at the labels.

• This atlas is posted in blackboard-- the resolution on screen is much better than in this handout.

• Please contact me if you have any questions.

Page 3: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Normal gomerulus

Page 4: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Epithelial cell(podocyte) parietal cell prox. tubule

Endothelial cell mesangial cell capillary lumen

Page 5: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Diagrammaticview of low power EM

Page 6: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Low power view ofNormal glomerulus

Page 7: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Low power view ofNormal glomerulus

Endothelial cell nucleus

Capillary lumen

Mesangial cell

Endothelial cell

Epithelial cell (podocyte)

Bowman’s space (urinarySpace)

Capillary lumen

RBC

Page 8: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Medium power EM ofa capillary loop

Page 9: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Medium power EM ofa capillary loop

Capillarylumen

Foot processes

Mesangial cell cytoplasm

Mesangial matrix

Parietal layer of bowman’scapsule

Urinary space

Endothelial cell nucleus

Endothelial cell fenestrations

Epithelial cell (podocyte)

Page 10: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Another capillary loop

Page 11: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Another capillary loop

Epithelial cell (podacyte)

Capillary lumen

RBC

Mesangial cell

Urinary space

Page 12: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

The glomerular capillarybasement membrane

Page 13: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

The glomerular capillarybasement membrane

Capillary lumen

Urinary space

Foot process

Epithelial cell

Endothelial cell

BM

Page 14: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Close up

of BM

Page 15: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Close up of Basement Membrane

Capillary lumen

Endothelial cell

fenestration

Lamina densa

Lamina raraexterna

Lamina rarainterna

Urinary space

Foot process

BM

Slit membrane

Epithelial cell

Page 16: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Proximal tubules- note hard to see cell borders

microvilli

Page 17: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Low power of proximaltubule

Page 18: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Low power of proximal tubule

Brush border

Tubular BM

InterdigitatedLateral process

Page 19: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Distal tubule

Page 20: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Distal tubule

lumenPlasma cell

Interstitial cell

Short villi

Page 21: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Collecting tubule/duct

Page 22: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Collecting tubule/duct

lumen

Page 23: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Classic Glomerular Disorders

• Please refer to these cases as we discuss them in class

• Think about the classic picture on light microscopy, immunofluorescence and electron microscopy and

• Explain the pathophysiology of the diseases

Page 24: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Acute proliferative

GN (post strep)

Page 25: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Acute proliferative

GN (post strep)

Page 26: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Hypercellular glomeruliIncreased # of cells

Normal glomerulus

Page 27: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

IF showing “lumpy-bumpy” pattern

Page 28: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Minimal changedisease

Page 29: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Minimal changedisease

Page 30: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Minimal change disease “normal” glomerulus by light microscopy

Page 31: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Minimal changedisease

Page 32: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Minimal changedisease

Page 33: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Membranous nephropathy thickened BM

Page 34: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Membranous GN

Page 35: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Membranous GN

Page 36: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Membranous GN

Page 37: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Membranous GN

Page 38: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Membranous GN

Page 39: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Diffuse proliferative lupus GN (WHO class IV) all glomeruli involved

Endothelial, epithelial, & mesangial proliferation, thrombosis of Capillaries (note few capillary lumens seen)

Page 40: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

IF in lupus nephritis anti-IgG

Page 41: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Proliferative lupus nephritis wire loop--subendothelial deposit

Page 42: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Lupus nephritis-Wire loops

Page 43: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Lupus nephritis-Wire loops

Page 44: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Lupus nephritis-Wire loops

Page 45: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Lupus nephritis-Wire loops

Page 46: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Lupus nephritis-Wire loops

Page 47: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Lupus nephritis-Wire loops

Page 48: Renal Ultrastructure Atlas Wm. J. Hunter M. D.. How to Use This Atlas These photos are meant to supplement your Jungueire text-atlas and Robbins by giving.

Lupus nephritis-Wire loops