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Electron Microscopy at SA Pathology

30 April 2020

SA Pathology offers a comprehensive electron microscopy service in ultrastructural pathology. Electron microscopy is an integral component of the diagnostic work-up for numerous native renal diseases and its importance is increasingly recognised in the early detection of chronic rejection in renal transplants. Electron microscopy also plays a vital role in the diagnosis of many other diseases including muscle and nerve disorders, tumours, disorders of cilia and lysosomal storage disorders.

SA Pathology’s Electron Microscopy Unit has operated within the Anatomical Pathology directorate since the early 70’s, and in 2010 incorporated electron microscopy services from the Flinders Medical Centre, Women’s and Children’s Hospital and The Queen Elizabeth Hospital.

The Unit provides a consultative service to pathologists and clinicians within South Australia and more broadly across Australia.

Case study

A 75-year-old male with a history of viral infections underwent a renal transplant biopsy to investigate his worsening graft function. Examination of the renal biopsy by light microscopy and immunofluorescence microscopy revealed no significant abnormality. However, examination by electron microscopy revealed abundant atypical mitochondria in proximal tubular cells (see image below). The mitochondria were enlarged and displayed an expanded matrix with only a few inner membranes (cristae) that had been marginalised to the organelle periphery. The ultrastructure was suggestive of tenofovir-induced nephrotoxicity. Further investigations revealed the patient was prescribed tenofovir as treatment for his ongoing viral infections. Tenofovir was considered the cause of the patient’s worsening renal function.