Arkana Laboratories
@arkanalabs
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Arkana Laboratories is a center for esoteric pathology focused on one thing: improving care for patients.
Little Rock, AR
Joined September 2012
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Today's
#eyeSCANdy
image shows glomerular tuft with overall intact architecture. Discrete masses of specular amyloid interrupt smooth uninvolved segments of capillary loop!
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Today’s
#eyeSCANdy
image shows acellular scanning EM showing a glomerulus with ischemic collapse.
Photo credits to Dr. Stephen Bonsib.
#renalpath
#pathart
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What is your leading diagnosis when seeing this finding along the glomerular capillary loops?
#kindeypath
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Today’s
#eyeSCANdy
image shows acellular scanning EM showing a glomerulus with ischemic collapse.
#PathTwitter
👀🍬🔬
Photo credits to Dr. Stephen Bonsib!
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What is your diagnosis in this renal allograft biopsy?
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Diagnose This!
An immunofluorescence panel for IgA, IgG, IgM, C3, C1q, kappa, and lambda was negative.
#kidneypath
#NephTwitter
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What is your diagnosis for this finding in a young patient with renal artery stenosis?
#DiagnoseThis
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What is your leading diagnosis when seeing this finding along the glomerular capillary loops?
#renalpath
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This scanning EM of a normal glomerulus shows a glomerular capillary loop with interdigitating podocyte foot processes.
#eyeSCANdy
👀🍬🔬
Photo credits to Dr. Stephen Bonsib!
#PathTwitter
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Time for another
#DiseaseWeek
tweetorial. How do we classify lupus nephritis?
The International Society of Nephrology and RPS created an LN classification system consisting of 6 classes of disease based on morphologic findings on kidney biopsy. A simplified view is below. /1
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Today’s
#eyeSCANdy
image shows calcium oxalate crystals in a urinary sediment under scanning electron microscopy!
#pathtwitter
📸 Courtesy of Dr. Stephen Bonsib.
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What is the name of the finding at the end of the arrow and what condition is it classically associated with?
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What is this finding? In a young male patient with hematuria and hearing loss, what would be your top diagnosis?
#kidneypath
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In a patient who is an IV drug user and IF showing C3 only staining, what is your diagnosis?
#kidneypath
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Today’s scanning EM of a normal glomerulus shows a glomerular capillary loop with interdigitating podocyte foot processes.
#eyeSCANdy
🔬👀🍬
Photo courtesy of Dr. Stephen Bonsib!
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This biopsy shows glomeruli with visceral epithelial cells (podocytes) displaying ample vacuolated cytoplasm (Fig 1), which is highlighted on a toluidine blue stain (Fig 2). More importantly, the electron microscopy shows numerous large, lamellated lipid vacuoles (myeloid bodies)
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This is the biopsy of a 47-year-old female with cervical cancer, on anti-VEGF therapy, with proteinuria and normal renal function. IF was negative.
#renalpath
#NephTwitter
What is your diagnosis?
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Studying for board exams? We want to help! Contact us for one of these flash drives of glomerular disease images and their diagnoses.
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Today’s
#eyeSCANdy
image shows acellular scanning EM showing a glomerulus with ischemic collapse.
#pathart
#renalpath
#PathTwitter
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What is your diagnosis in a 35 y/o male with paraplegia and chronic osteomyelitis who presents with nephrotic syndrome? Bonus: What subtype would you suspect based on the clinical history?
#DiagnoseThis
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What is your diagnosis? (Congo red is negative as is routine immunofluorescence)
#PathTwitter
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What is this finding? In a young male patient with hematuria and hearing loss, what would be your top diagnosis?
#DiagnoseThis
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108
What is your diagnosis? (Congo red is negative as is routine immunofluorescence)
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What conditions would be in your differential diagnosis for this finding?
#kidneypath
(Hint: large glomerulus)
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This is the biopsy from a 73-year-old with AKI and normal bone marrow biopsy done for investigation of anemia and thrombocytopenia. What is your diagnosis?
#PathTwitter
#renalpath
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In a patient who is IV drug user and IF showing C3 only staining, what is your diagnosis?
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Today’s
#eyeSCANdy
image shows dysmorphic red blood cells from the urine of a patient with crescentic glomerulonephritis!
#nephropath
📸 Courtesy of Dr. Stephen Bonsib.
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What is your diagnosis?
(Congo red is negative as is routine immunofluorescence)
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This
#eyeSCANDy
image is an acellular scanning EM from a biopsy with membranous glomerulonephritis, stage I showing numerous small shallow depressions representing the site of immune complexes which were extracted corresponding to “pinholes” viewed on silver stain.
#pathart
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This is the biopsy from a 41yo Middle Eastern female who received a renal transplant a few years prior and presents with AKI. What is your diagnosis?
#nephropath
#NephTwitter
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Today’s
#eyeSCANdy
image shows acellular scanning EM from a biopsy with membranous glomerulonephritis, stage I with numerous small shallow depressions representing the site of immune complexes which were extracted corresponding to “pinholes” viewed on silver stain.
#pathart
5
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Time for another
#LupusLesson
. How do we classify lupus nephritis?
The International Society of Nephrology (ISN) and Renal Pathology Society (RPS) created a lupus nephritis classification system consisting of 6 classes of disease based on morphologic findings on kidney biopsy.
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105
What is the most likely diagnosis in a patient with an abnormal serum protein electrophoresis?
#DiagnoseThis
#NephTwitter
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What is your diagnosis in a patient (non-smoker) with worsening proteinuria and a negative immunofluorescence panel?
#renalpath
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In a patient with subnephrotic proteinuria, negative immunofluorescence, and segmental foot process effacement, what is your diagnosis?
#NephTwitter
#renalpath
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What is your presumed diagnosis in the absence of immunofluorescence and electron microscopy?
#renalpath
#PathTwitter
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Today’s
#eyeSCANdy
image shows scanning EM of a normal glomerulus with a glomerular capillary loop with interdigitating podocyte foot processes.
#pathart
🍬👀🔬
📸 credits to Dr. Stephen Bonsib!
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What stain would you order to clinch the diagnosis in this transplant patient with AKI?
#DiagnoseThis
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This is a 3 month post-transplant kidney biopsy from a patient with ESRD due to polycystic kidney disease. She recently developed CMV disease and AKI (Creatinine is 5.4 from a baseline of 1.4mg.dl). What is your diagnosis?
#NephTwitter
#nephropath
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This image is from a biopsy of a young female who presented with proteinuria during pregnancy. Routine immunofluorescence was negative. What is this stain and what is your diagnosis?
#kidneypath
#NephTwitter
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This is the IgG immunofluorescence from the biopsy of a 75-year-old female with AKI requiring dialysis. What is your diagnosis?
#NephTwitter
#kidneypath
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Happy
#ValentinesDay2022
! 💘
This diagnostic image of a renal biopsy shows acute tubular injury on H&E stain.
#nephropath
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What is your diagnosis? (Congo red is negative as is routine immunofluorescence)
#kidneypath
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Happy Labor Day! This image shows a diffuse mesangial expansion in early diabetic nephropathy on trichrome stain.
Our offices are closed today but will resume normal hours on September 8th.
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Happy
#StPatricksDay
! ☘️
Enjoy this IF image with C3 rings used to diagnose dense deposit disease.
#pathart
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Presence of these favors a membranous lupus nephritis over primary membranous:
1.Mesangial deposits
2.Subendothelial deposits
3.C1q deposits
4.“Full house” immunofluorescence
5.TBM deposits
6.Tissue ANA
7.Tubuloreticular inclusions
8.Negative PLA2R
#DiseaseWeek
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Welcome to ANCA-associated Vasculitis (AAV) Disease Week!
This week,
@ClarissaCassol
will walk us through the history, pathogenesis, pathological features, disease classification, prognosis, and recent advances in the management of ANCA-associated vasculitis.
#DiseaseWeek
/1
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What conditions would be in your differential diagnosis for this finding? (Hint: large glomerulus)
#DiagnoseThis
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What is your diagnosis for this finding in a young patient with renal artery stenosis?
#renalpath
#pathtwitter
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What is the most likely diagnosis? For bonus points, what is the basic differential for this morphologic finding (non-immune and immune)?
#renalpath
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In a patient with RPGN and this morphological finding on biopsy, what is the most likely diagnosis?
#renalpath
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This is the IgG IF of a biopsy from a 14yo boy with AKI and hematuria. What would you be your top differential?
#kidneypath
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What is the most likely diagnosis in a patient with an abnormal serum protein electrophoresis?
#Nephpearls
#renalpath
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This
#eyeSCANdy
scanning EM image of a normal glomerulus shows a glomerular capillary loop with interdigitating podocyte foot processes.
Photo credits to Dr. Stephen Bonsib!
#nephropath
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Introducing the No Cost to Patient APOL1 Genotyping Program for eligible patients sponsored by
@VertexPharma
.
See if your patients are eligible or learn more about APOL1 high-risk variants.
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This is the biopsy of a patient with a mechanical heart valve and acute kidney injury, requiring hemodialysis. What is your diagnosis?
#renalpath
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How has your own practice of diagnosing and treating patients with TMA changed in the last few years?
#KDIGO
#Nephpearls
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This is the biopsy of a 32yo IV drug user who has nephrotic range proteinuria and MSSA bacteremia secondary to a skin abscess. What is this stain and what is your diagnosis?
#DiagnoseThis
#NephTwitter
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The immunofluorescence image shown is of IgA. What is the most likely diagnosis and clinical history?
#renalpath
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What is your diagnosis in a patient with a particular “gray” appearance to their complexion?
#kidneypath
#pathtwitter
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What is the name of the finding at the end of the arrow and what condition is it classically associated with?
#nephropath
#PathTwitter
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This acellular scanning EM from a biopsy with membranous glomerulonephritis, stage 1️⃣ shows numerous small shallow depressions and occasional larger foci forming shallow "craters" along the subepithelial aspect of the basement membrane. 👀🍬
#eyeSCANdy
📸 credits to Dr. Bonsib!
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Today’s
#eyeSCANdy
image shows corrugated lumen of a renal artery following removal of endothelial cells!
#kidneypath
Image courtesy of Dr. Stephen Bonsib
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What is your diagnosis in a patient (non-smoker) with worsening proteinuria and a negative immunofluorescence panel?
#DiagnoseThis
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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)
#kidneypath
#NephTwitter
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This is the albumin immunofluorescence stain from a biopsy from a patient with recent COVID pneumonia and nephrotic syndrome. What is your diagnosis?
#kidneypath
#NephTwitter
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What would be your leading diagnosis in a patient with elevated ACE levels and hilar lymphadenopathy?
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#TeachingPoint
Membranous glomerulopathy (MG) is a common cause of nephrotic syndrome that results from the formation of immune complexes along the subepithelial aspect of the glomerular basement membranes. Approximately 1% of membranous cases will show light chain restriction by
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#TeachingPoints
Patients with warfarin-related nephropathy present with an acute rise in serum Cr after becoming supratherapeutic on warfarin therapy (INR>3). The renal biopsy findings of warfarin nephropathy include acute tubular injury, occlusive RBC casts in tubular lumens,
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