Anatomic Pathology Consult Page

Renal Pathology

The Renal Pathology Laboratory, a nationally known center for renal biopsies, serves nephrologists, transplant surgeons, and others by providing the most effective methodology available for diagnosing renal disease and managing renal patients.

We provide renal biopsy interpretation for nephrologists throughout the country. As one of the few such services in this region, we are particularly well positioned to serve the mid-Atlantic states with rapid turnaround. Our lab can also accommodate central slide review for selected clinical studies.

Lab Hours
8:00 a.m. to 5:30 p.m., Monday through Friday. Weekend biopsy interpretation available on request.

Experience

The Renal Pathology Lab has always been at the forefront of the field. We have performed and interpreted renal biopsies since the 1950s, and have been performing full-service biopsies with electron microscopy and immunofluorescence since the 1970s. We currently provide the latest in immunohistochemistry and molecular techniques. Our service was started by Dr. Heptinstall, one of the founders of the field of renal pathology and still active as a consultant here.

Expertise

Expert Consultation
The service is overseen by one of the best renal pathology groups in the country, with three internationally known specialists on the faculty. In addition to Dr. Serena Bagnasco professor and Director of service, staff include Dr. Lorraine Racusen and Dr. Lois Arend. Faculty interests include glomerular diseases, tubular diseases and injury and allograft pathology. Faculty members provide ongoing consultation to laboratory customers and, as results are obtained, provide diagnosis, prognosis, and expert advice on how to treat and manage the patient.

Special capabilities and services
Staff can perform electron microscopy from paraffin-embedded tissue or unstained slides, immunofluorescence studies on paraffin-embedded tissue, and a variety of immunohistologic and selected molecular studies.

Timely Results

Tests results and diagnoses can be provided quickly,usually within 12-24 hours for histology and immunohistology. Interim results can be reported as soon as they are available, to be followed by a full written report.

Test results can be speeded by phone, fax, or e-mail. If requested, we can send representative microscopic slides, electron microscopy prints, or Kodachromes of immunohistology tests for you to review, verify, or present at clinical conferences. We are also equipped to send these documents for joint consultations by computer.

Faculty

Dr. Serena Bagnasco

Serena M. Bagnasco, M.D.

Phone: 410-502-0812
Fax: 410-614-7110
E-mail:

Education and Training

Professional Interests
Nephropathology, Research in Renal Physiology

Major Professional Leadership


Dr. Lorraine Racusen

Lorraine C. Racusen, MD, FCAP

Phone: 410-955-3437
Fax: 410-550-5158
E-mail:

Education and Training

Professional Interests
Nephropathology

Notable Accomplishments
Co-author of the major schema used for renal allograft rejection diagnosis. Funded laboratory investigator.

Major Professional Leadership

Tests

To order, call Consult office at 410-955-2405 between 8:00 a.m. and 5:00 p.m.

To send consult slides
Forward slides by courier or express mail to:
Johns Hopkins Medical Laboratories
1620 McElderry Street
Reed Hall Rm 315
Baltimore, MD 21205
 Phone 410-955-2405
Fax 410-614-7712

To send biopsies, e-mail us at:

Deliveries Monday through Friday 8am-4:30pm

Deliver to:
Johns Hopkins Medical Institutions
Department of Pathology
ATTN: Surgical Pathology - Renal
Pathology Bldg 700
600 N. Wolfe Street
Baltimore, MD 21287

For questions or concerns during delivery please call the following in order:


Deliveries after hours and weekends

Johns Hopkins Medical Institutions
Department of Pathology
ATTN: Surgical Pathology - Renal
401 N. Broadway
2nd Floor Security Desk
Baltimore, MD 21231-2410
410-955-2647 Customer Service
410-283-3316 (Renal Attending - On-Call)

For weekend biopsies an advanced call and/or follow up call is recommended.

Interpretations of standard and specialized studies are provided by experienced specialists of both native kidney and allograft pathology. Turnaround times for reporting results vary by test and are listed below.

Standard renal biopsy processing
The laboratory provides expert standard processing of native kidney and allograft renal biopsies, using light microscopy with immunofluorescence and/or electron microscopy as appropriate for each case. Studies can be done on tissue or on blocks of slides prepared elsewhere.

Available Tests
Light Microscopy (LM) - H&E, trichrome, PAS, and silver stains
Immunofluorescence (IF) - Immunoglobulins, complement components, light chains, Alport panel (alpha chains of type 4 collagen), IgG subclasses
Electron microscopy (EM)

Turnaround time for:
Routine processing and interpretation for light microscopy and immunofluorescence - 1 day
Routine processing and interpretation for electron microscopy - 5 days
Rush processing for LM and IF, on request - 4 to 6 hours
Electron microscopy - 2 days if needed

Specialized studies
Studies are available as needed on routinely processed specimens or can be applied to slides or tissue blocks sent in consultation.

Tests
Immunoperoxidase (immunoglobins, immunoglobulin light chains, immunoglobulin heavy chains, amyloid AA, viral antigens, myoglobin, cell surface markers) Immunoelectron microscopy
Preparation of EM specimens from paraffin-embedded material or tissue sections on slides
In situ hybridization (viral antigens)

Turnaround time for:
Immunoperoxidase and in situ hybridization - 1 to 2 days
Immunoelectron microscopy - within 3 to 4 days

Special Ordering Instructions

Standard Specimen Processing
There are two major options for preparing and sending renal biopsy material for evaluation:

Method I (Use for transport times greater than a few hours):


Method II (Use for transport times of up to several hours):


FOR BOTH METHODS: