The Evolving Revolution of Pathology’s Role in Renal Medical Diseases (Special Section–Renal Pathology) (Report)
Renal pathology has always been considered an “exotic” area of pathology. Perhaps more than one reason accounts for this perception. Limited exposure to renal pathology, reflecting the fact that kidney biopsies for medical renal diseases are not a common specimen and are mostly sent to specialized centers rather than being handled at local hospitals, is probably one of the most important reasons for this perception. The complexity of integrating different diagnostic modalities, including light microscopy, immunofluorescence, and electron microscopy, is perhaps another reason. Furthermore, proper renal biopsy interpretation usually requires significant clinical knowledge. The observation that very similar morphologic findings in renal biopsies may signify diseases of quite different nature and pathogenesis, impacting treatment and prognosis, is certainly somewhat unusual and daunting in diagnostic pathology. Yet, knowledge in renal pathology is important in the daily practice. Correct handling of the renal biopsies to be sent for outside consultation, understanding the diagnostic and biologic significance of the renal biopsy reports, and effective communication with the referring nephrologists all depend on a significant understanding of various aspects of renal diseases from a morphologic perspective. Furthermore, the entire spectrum of renal medical diseases can be seen in the context of nephrectomy for neoplastic or nonneoplastic conditions. It is the responsibility of the general pathologist to make a correct diagnosis in the uninvolved renal parenchyma of these nephrectomy specimens.