Images in pathology: congo-red negative fibrillary glomerulonephritis.
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Biomedical subjects
Surya V Seshan
Publications and source records attributed to Surya V Seshan.
Noninvasive diagnosis of BK virus nephritis by measurement of messenger RNA for BK virus VP1 in urine.
BACKGROUND: Polyoma virus type BK (BKV) nephritis has emerged as an important cause of renal allograft dysfunction and graft failure. Its diagnosis is contingent on the invasive procedure of allograft biopsy. A noninvasive diagnostic test for BKV nephritis could improve clinical outcome. METHODS: We obtained 25 urine specimens from 8 renal allograft recipients with biopsy-confirmed BKV nephritis, 31 samples from 28 recipients in whom BKV nephritis was excluded by allograft biopsy, and 74 specimens from 34 patients with stable allograft function. RNA was isolated from the urinary cells and reverse transcribed to complementary DNA. We designed gene-specific oligonucleotide primers and probes for the measurement of messenger RNA (mRNA) encoding BKV VP1 protein and a constitutively expressed 18S ribosomal RNA (rRNA) by real-time quantitative polymerase chain reaction. We explored the hypothesis that BKV VP1 mRNA levels predict BKV nephritis. RESULTS: The levels of BKV VP1 mRNA but not the levels of 18S rRNA predicted BKV nephritis. Analysis involving the receiver operating characteristic curve demonstrated that BKV nephritis can be predicted with a sensitivity of 93.8% and a specificity of 93.9% with the use of a cutoff value of 6.5 x 10 BKV VP1 mRNA copy number per nanogram of total RNA ( <0.00001). In the receiver operating characteristic curve analysis, the calculated area under the curve was 0.949 (95% confidence interval, 0.912 to 0.987, <0.00001) for BKV VP1 mRNA levels and 0.562 (95% confidence interval, 0.417 to 0.708, >0.2) for 18S rRNA. CONCLUSIONS: Measurement of BKV VP1 mRNA in urinary cells offers a noninvasive and accurate means of diagnosing BKV nephritis.
Adult↗
Aspiration cytology of elastofibroma dorsi: case report with ultrastructural and immunohistochemical findings.
Elastofibroma is a well-recognized tumor-like process which typically occurs in the soft tissue of the shoulder. Although fine-needle aspiration (FNA) represents a quick and simple method for definitive diagnosis, the possibility of a false-negative diagnosis is high due to the hypocellularity of the smears. However, a high index of suspicion based on the clinical presentation of a firm mass in a typical location in an elderly person, usually female, aids in the diagnosis. We describe the FNA findings of elastofibroma dorsi in an 89-yr-old woman which, although hypocellular, contained diagnostic aggregates of petaloid globules within a collagenous matrix. The cytologic material showed a green-yellow autofluorescence of the altered elastic fibers with ultraviolet light. Transmission electron microscopy revealed an elongated beaded appearance with small electron densities and obliteration of the central elastin core. The presence of a hypocellular aspirate with autofluorescent elastic fibers should suggest the possibility of elastofibroma dorsi.
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