Pathological diagnosis of antibody-mediated rejection in renal allograft without c4d staining, how much reliable?

BACKGROUND: C4d as a part of complement activation process is a marker for detecting antibody-mediated rejection (ABMR) and its positivity accompanied by positive donor specific antibody (DSA), and morphologic view of humoral rejection has been suggested to detect ABMR since 2003. MATERIALS AND METHODS: 41 specimens of transplanted kidney biopsies gathered from 2006 to 2008 were evaluated for morphological changes on light microscopy, and nephro-pathologist made distinct diagnosis for all of specimens then c4d staining was done for all of them. The association between primary diagnosis without c4d staining and c4d scoring on peritubular capillaries and glomerular capillaries were evaluated to determine whether morphological changes were enough for distinct diagnosis or not. RESULTS: Acute tubular necrosis (ATN) 27%, interstitial fibrosis and tubular atrophy (IF&TA) 17%, and T cell mediated rejection (TCMR) 22% were the commonest diagnosis on light microscopy, and 17% of all biopsies had diffuse positive c4d staining. There was not any report of ABMR in morphological evaluation while c4d positive staining was seen in some specimens (17%). It may result from masking of ABMR by other morphological changes such as TCMR and no specific histologic changes for ABMR on light microscopy. CONCLUSION: We would like to emphasize that c4d staining should be done for all of renal allograft biopsies, and pathologists all over the world should consider the probability of ABMR masked by other morphological changes on light microscopic evaluation.

An automated method for segmentation of epithelial cervical cells in images of ThinPrep.

We present an automated method for segmentation of epithelial cells in images taken from ThinPrep scenes by a digital camera in a cytology lab. The method covers both steps of localization of cell objects in low resolution and detection of cytoplasm and nucleus boundary in high resolution. The underlying method makes use of geometric active contours as a powerful tool of segmentation. We also provide the analysis of the connected cells. For this purpose an automatic circular decomposition method is incorporated and adapted to the application by changing its segmentation condition. The results are evaluated numerically and compared with those of previous work in literature.