Your pathologists are right. A histotechnologist or the electron microscopy
technologist needs to show up with a small dissecting microscope and look at
each core of renal tissue as it is removed from the patient. Look for the
small faint pink "blushes" of the glomeuli on the surface of the tissue to be
sure renal cortex has been collected. Medulla has a circular, streaky
appearance while perirenal fat has a glubular appearance. It is time well
spent. The biopsy is so important to the patient, and later, the electron
microscopy technologist will have to look for glomuli in their portion which
can take hours if there are not too many there!

When collecting the core, place it on a saline damped gauze in a petri dish
while looking at it and until you get back to the lab to stop it drying out.
At the time of collection remember you set up is not sterile while the
nephrologist or radiolologist is working in a sterile field. Later the
specimen is split up for light microscopy, electron microscopy and
immunofluorescence microscopy.

I know of no regulations or guidelines for evaluating renal biopsies. My
experience has been that in teaching hospitals, there is such a turnover of
MD staff that sometimes you have to be there to make sure no errors in
specimen collection occurs. If you have a good rapport with your
nephrologist/radiologist/ultrasound tech maybe you can show them what to do.

Mike Titford
Pathology
USA Medical Center
Mobile AL