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Renal Pathology

A Subspecialty Of  Anatomic Pathology

About Renal Pathology

Stanford’s Renal Pathology Practice provides comprehensive diagnostic expertise and services for medical diseases (non-tumor) of the kidneys. To obtain a diagnosis for these cases, the renal pathologist will synthesize findings from a range of supporting studies including: light microscopy, electron microscopy, immunofluorescence and immunohistochemistry. The service also reviews renal transplant biopsies to identify possible rejection of the transplanted organ as well as evaluate for drug toxicity and infections.

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Our Faculty

Ancillary Testing

 

Stanford’s Renal Pathology Service provides diagnostic expertise for non-neoplastic kidney cases in both adult and pediatric population. We offer a full range of diagnostic evaluation for primary glomerular, tubulointerstitial, and vascular diseases of the kidney, and systemic diseases such as lupus and systemic vasculitides. Renal pathology cases require extensive clinical-pathological correlation and as such, clinical information provided (eg. serum creatinine, serological studies for hepatitis and lupus, and the degree of proteinuria) are incorporated into the interpretation of the renal biopsy.

The Medical Renal Pathology Service also reviews biopsies of transplanted kidneys to identify possible rejection, infections and drug toxicity of the transplanted organ. Our team provides diagnostic excellence for evaluation of allograft biopsies in both adult and pediatric population.

Renal biopsies are evaluated routinely by the three modalities of light microscopy, immunofluorescence microscopy, electron microscopy and as needed, immunohistochemistry.

Our service includes assignment of a renal pathology fellow/faculty to each case for individualized service, including call-backs with updates and final results. The renal Pathology Service also offers Nephrologists direct access to the service via an on-call cell phone staffed by an on-service faculty member.

 

Consultative Opinions & Case Reviews

When a Pathologist, Nephrologist or patient not being treated at Stanford has a challenging renal pathology case, has a specific question pertaining to further management, or would like a second opinion, their pathology material can be sent for review to the consult service. One of our renal pathology faculty will provide their consultative opinion on the case.

 

Primary Pathology Diagnosis

Stanford’s Medical Renal Pathology Service performs gross and microscopic examination and reporting of wet tissue cases including routine evaluation via light microscopy, immunofluorescence and electron microscopy.

Preliminary light microscopic and immunofluorescence and/or immunohistochemical results are called or faxed to the referring physician within 12-24 hours from receipt of the specimen. Final diagnosis including electron microscopy results are typically reported within three to four working days from receipt of the specimen.

Consult Cases

To submit slides for case review, please fill out a Stanford requisition form and include all slides, relevant clinical documents, and ancillary testing materials and reports. If possible, please include a block, as it will expedite the finalization of the case should additional testing be necessary. Package all materials securely and send via a padded envelope.

 

Wet Tissue Specimens

Stanford offers a renal biopsy collection kit with specimen containers for light microscopy, immunofluorescence and electron microscopy. Please call 650-725-5196 to request kidney biopsy kits.

All samples should be labeled with the patient information (Name, date of birth, patient address, and one other unique identifier) and sealed in a biohazard bag.

 

Renal Biopsies

Learn more about proper collection and handling of renal biopsies:

Renal Biopsy collection instructions

We do offer stat requests for same day and weekend review as clinically indicated. To send a STAT case, please contact the on-call renal cell phone and clearly indicate on the requisition who to call with the preliminary results. Nephrologists have direct cell phone access to the on call Renal Pathologist.

 

Samples and consult materials should be shipped or delivered via courier to:

Stanford Surgical Pathology – Consults:
Attn: Renal Pathology

300 Pasteur Drive, Room H2110
Stanford, CA 94305
Phone: 650-723-7211
Fax: 650-725-7409

Stanford Surgical Pathology – Wet Tissue:
Attn: Renal Pathology

3375 Hillview Avenue
Palo Alto, CA 94304
Phone: 650-723-7211
Fax: 650-725-7409

On-Call Renal Pathology Phone (Pathologist staffed):
650-391-5338

To request a Renal Biopsy Collection Kit, please contact the EM lab:
650-725-5196

Renal Pathology Requisition

 

New Client Inquiries

To arrange to be set up as a new client, please contact:
ClinOpsContracts@stanfordhealthcare.org.

 

Contact Us

To submit a specimen to Renal Pathology, please complete a requisition and send with sample to:

 

Stanford Renal Pathology Service

300 Pasteur Drive, Room H2110
Stanford, CA 94305

Phone: 650-723-7211
Fax (650) 725-7409

 

On-Call Renal Pathology Phone: 650-391-5338

(Pathologist staffed)

To request a Renal Biopsy Collection Kit, please contact: 650-725-5196

 

Medical Director:
Neeraja Kambham, MD

 

To arrange to be set up as a new client, please contact:
ClinOpsContracts@
stanfordhealthcare.org

 

Download Renal Pathology Requisition

SAMPLE SUBMISSION LOGISTICS
For more information on submitting cases, see the links below:

All Requisitions
Download Stanford Requisitions for specimen submission.

Account Set-up
Information on personalized requisitions, supplies, shipping and courier pick-up.

Pricing Inquiries
Pricing inquiries and contract information.

Billing
Billing policies, information and questions.

Results Web Portal
Request access or log-in to our client results portal.

Specimen Collection and Handling
Specifications for Specimen Collection and Handling.

Consult Service FAQ's
Get answers to Frequently Asked Questions.

Neeraja Kambham, MD

Neeraja Kambham, MD

APPOINTMENTS

  • Director, Anatomic Pathology
  • Service Director, Renal Pathology
  • Program Director, Renal Pathology Fellowship
  • Professor of Pathology

PRACTICE AREAS

  • Renal Pathology
  • Medical Liver Pathology
  • Anatomic Pathology

CONTACT

Email: neeraja.kambham@stanford.edu
Phone: (650) 725-5193

More information about Neeraja Kambham:
https://med.stanford.edu/profiles/neeraja-kambham
https://profiles.stanford.edu/neeraja-kambham

John Higgins, MD

John Higgins, MD

APPOINTMENTS

  • Residency Program Director for Anatomic and Clinical Pathology
  • Professor of Pathology
  • Co-Director, Post-Sophomore Fellowship in Pathology

PRACTICE AREAS

  • Liver Pathology
  • GI Pathology
  • Renal Pathology
  • Transplant Pathology
  • Pathology and Laboratory Medicine
  • Anatomic and Clinical Pathology

CONTACT

Email: john.higgins@stanford.edu
Phone: (650) 723-7211

More information about John Higgins:
https://med.stanford.edu/profiles/john-higgins
https://profiles.stanford.edu/john-higgins

Richard K. Sibley, MD

Richard K. Sibley, MD

APPOINTMENTS

  • Emeritus Professor of Pathology

PRACTICE AREAS

  • Anatomic Pathology
  • Pathology

CONTACT

Email: Richard.Sibley@stanford.edu
Phone: (650) 723-8002

More information about Richard Sibley:
https://med.stanford.edu/profiles/richard-sibley
https://profiles.stanford.edu/richard-sibley

Megan Troxell, MD, PhD

Megan Troxell, MD, PhD

APPOINTMENTS

  • Professor of Pathology
  • Co-Director, Surgical Pathology 

PRACTICE AREAS

  • Anatomic Pathology
  • Breast Pathology
  • Renal Pathology
  • Genitourinary Pathology
  • Transplant Pathology

CONTACT

Phone: (650) 723-1410

More information about Megan Troxell:
https://med.stanford.edu/profiles/megan-troxell
https://profiles.stanford.edu/megan-troxell

Ancillary Testing

Renal Pathology relies heavily on a suite of ancillary testing offerings to support our expert diagnosis. Each case incorporates three modalities of light microscopy, , immunofluorescence, electron microscopy and as needed immunohistochemistry.

 

Immunohistochemistry

Immunohistochemical staining for polyoma virus, cytomegalovirus and other viruses, serum amyloid A, B-and T-lymphocyte subsets, IgG & IgG4 heavy chain, Nell-1and C4d can be performed on formalin fixed tissue sections (obtained from submitted paraffin blocks or unstained sections). Our IHC lab test menu is comprehensive and includes immunohistochemical and in-situ hybridization stains.

Immunofluorescence

We perform direct immunofluorescence on frozen tissue samples. Routine testing includes staining for C3, IgG, IgM, IgA, C1q, kappa, lambda, fibrinogen, and albumin. Additional antibodies that may be applied to the tissue include a2 and a5 chains of type IV collagen, Fibronectin, IgG heavy chain subclass identification (IgG1-4), and PLA2R. We also perform antigen retrieval immunofluorescence on formalin-fixed paraffin embedded tissue using pronase digestion.

Electron Microscopy

Electron microscopy is used to confirm and/or establish a diagnosis.

Our Services

Stanford’s Renal Pathology Service provides diagnostic expertise for non-neoplastic kidney cases in both adult and pediatric population. We offer a full range of diagnostic evaluation for primary glomerular, tubulointerstitial, and vascular diseases of the kidney, and systemic diseases such as lupus and systemic vasculitides. Renal pathology cases require extensive clinical-pathological correlation and as such, clinical information provided (eg. serum creatinine, serological studies for hepatitis and lupus, and the degree of proteinuria) are incorporated into the interpretation of the renal biopsy.

The Medical Renal Pathology Service also reviews biopsies of transplanted kidneys to identify possible rejection, infections and drug toxicity of the transplanted organ. Our team provides diagnostic excellence for evaluation of allograft biopsies in both adult and pediatric population.

Renal biopsies are evaluated routinely by the three modalities of light microscopy, immunofluorescence microscopy, electron microscopy and as needed, immunohistochemistry.

Our service includes assignment of a renal pathology fellow/faculty to each case for individualized service, including call-backs with updates and final results. The renal Pathology Service also offers Nephrologists direct access to the service via an on-call cell phone staffed by an on-service faculty member.

 

Consultative Opinions & Case Reviews

When a Pathologist, Nephrologist or patient not being treated at Stanford has a challenging renal pathology case, has a specific question pertaining to further management, or would like a second opinion, their pathology material can be sent for review to the consult service. One of our renal pathology faculty will provide their consultative opinion on the case.

 

Primary Pathology Diagnosis

Stanford’s Medical Renal Pathology Service performs gross and microscopic examination and reporting of wet tissue cases including routine evaluation via light microscopy, immunofluorescence and electron microscopy.

Preliminary light microscopic and immunofluorescence and/or immunohistochemical results are called or faxed to the referring physician within 12-24 hours from receipt of the specimen. Final diagnosis including electron microscopy results are typically reported within three to four working days from receipt of the specimen.


close Our Services
Submit a Specimen

Consult Cases

To submit slides for case review, please fill out a Stanford requisition form and include all slides, relevant clinical documents, and ancillary testing materials and reports. If possible, please include a block, as it will expedite the finalization of the case should additional testing be necessary. Package all materials securely and send via a padded envelope.

 

Wet Tissue Specimens

Stanford offers a renal biopsy collection kit with specimen containers for light microscopy, immunofluorescence and electron microscopy. Please call 650-725-5196 to request kidney biopsy kits.

All samples should be labeled with the patient information (Name, date of birth, patient address, and one other unique identifier) and sealed in a biohazard bag.

 

Renal Biopsies

Learn more about proper collection and handling of renal biopsies:

Renal Biopsy collection instructions

We do offer stat requests for same day and weekend review as clinically indicated. To send a STAT case, please contact the on-call renal cell phone and clearly indicate on the requisition who to call with the preliminary results. Nephrologists have direct cell phone access to the on call Renal Pathologist.

 

Samples and consult materials should be shipped or delivered via courier to:

Stanford Surgical Pathology – Consults:
Attn: Renal Pathology

300 Pasteur Drive, Room H2110
Stanford, CA 94305
Phone: 650-723-7211
Fax: 650-725-7409

Stanford Surgical Pathology – Wet Tissue:
Attn: Renal Pathology

3375 Hillview Avenue
Palo Alto, CA 94304
Phone: 650-723-7211
Fax: 650-725-7409

On-Call Renal Pathology Phone (Pathologist staffed):
650-391-5338

To request a Renal Biopsy Collection Kit, please contact the EM lab:
650-725-5196

Renal Pathology Requisition

 

New Client Inquiries

To arrange to be set up as a new client, please contact:
ClinOpsContracts@stanfordhealthcare.org.

 

Contact Us

To submit a specimen to Renal Pathology, please complete a requisition and send with sample to:

 

Stanford Renal Pathology Service

300 Pasteur Drive, Room H2110
Stanford, CA 94305

Phone: 650-723-7211
Fax (650) 725-7409

 

On-Call Renal Pathology Phone: 650-391-5338

(Pathologist staffed)

To request a Renal Biopsy Collection Kit, please contact: 650-725-5196

 

Medical Director:
Neeraja Kambham, MD

 

To arrange to be set up as a new client, please contact:
ClinOpsContracts@
stanfordhealthcare.org

 

Download Renal Pathology Requisition

SAMPLE SUBMISSION LOGISTICS
For more information on submitting cases, see the links below:

All Requisitions
Download Stanford Requisitions for specimen submission.

Account Set-up
Information on personalized requisitions, supplies, shipping and courier pick-up.

Pricing Inquiries
Pricing inquiries and contract information.

Billing
Billing policies, information and questions.

Results Web Portal
Request access or log-in to our client results portal.

Specimen Collection and Handling
Specifications for Specimen Collection and Handling.

Consult Service FAQ's
Get answers to Frequently Asked Questions.


close Submit a Specimen
Our Faculty

Neeraja Kambham, MD

Neeraja Kambham, MD

APPOINTMENTS

  • Director, Anatomic Pathology
  • Service Director, Renal Pathology
  • Program Director, Renal Pathology Fellowship
  • Professor of Pathology

PRACTICE AREAS

  • Renal Pathology
  • Medical Liver Pathology
  • Anatomic Pathology

CONTACT

Email: neeraja.kambham@stanford.edu
Phone: (650) 725-5193

More information about Neeraja Kambham:
https://med.stanford.edu/profiles/neeraja-kambham
https://profiles.stanford.edu/neeraja-kambham

John Higgins, MD

John Higgins, MD

APPOINTMENTS

  • Residency Program Director for Anatomic and Clinical Pathology
  • Professor of Pathology
  • Co-Director, Post-Sophomore Fellowship in Pathology

PRACTICE AREAS

  • Liver Pathology
  • GI Pathology
  • Renal Pathology
  • Transplant Pathology
  • Pathology and Laboratory Medicine
  • Anatomic and Clinical Pathology

CONTACT

Email: john.higgins@stanford.edu
Phone: (650) 723-7211

More information about John Higgins:
https://med.stanford.edu/profiles/john-higgins
https://profiles.stanford.edu/john-higgins

Richard K. Sibley, MD

Richard K. Sibley, MD

APPOINTMENTS

  • Emeritus Professor of Pathology

PRACTICE AREAS

  • Anatomic Pathology
  • Pathology

CONTACT

Email: Richard.Sibley@stanford.edu
Phone: (650) 723-8002

More information about Richard Sibley:
https://med.stanford.edu/profiles/richard-sibley
https://profiles.stanford.edu/richard-sibley

Megan Troxell, MD, PhD

Megan Troxell, MD, PhD

APPOINTMENTS

  • Professor of Pathology
  • Co-Director, Surgical Pathology 

PRACTICE AREAS

  • Anatomic Pathology
  • Breast Pathology
  • Renal Pathology
  • Genitourinary Pathology
  • Transplant Pathology

CONTACT

Phone: (650) 723-1410

More information about Megan Troxell:
https://med.stanford.edu/profiles/megan-troxell
https://profiles.stanford.edu/megan-troxell


close Our Faculty
Ancillary Testing

Ancillary Testing

Renal Pathology relies heavily on a suite of ancillary testing offerings to support our expert diagnosis. Each case incorporates three modalities of light microscopy, , immunofluorescence, electron microscopy and as needed immunohistochemistry.

 

Immunohistochemistry

Immunohistochemical staining for polyoma virus, cytomegalovirus and other viruses, serum amyloid A, B-and T-lymphocyte subsets, IgG & IgG4 heavy chain, Nell-1and C4d can be performed on formalin fixed tissue sections (obtained from submitted paraffin blocks or unstained sections). Our IHC lab test menu is comprehensive and includes immunohistochemical and in-situ hybridization stains.

Immunofluorescence

We perform direct immunofluorescence on frozen tissue samples. Routine testing includes staining for C3, IgG, IgM, IgA, C1q, kappa, lambda, fibrinogen, and albumin. Additional antibodies that may be applied to the tissue include a2 and a5 chains of type IV collagen, Fibronectin, IgG heavy chain subclass identification (IgG1-4), and PLA2R. We also perform antigen retrieval immunofluorescence on formalin-fixed paraffin embedded tissue using pronase digestion.

Electron Microscopy

Electron microscopy is used to confirm and/or establish a diagnosis.


close Ancillary Testing

Residencies and Fellowships

Anatomic Pathology Residency Programs

Stanford Pathology offers a 3-year Anatomic Pathology residency and 4 year combination residencies in Anatomic Pathology/Clinical Pathology and Anatomic Pathology/Neuropathology.

 

Renal Pathology Fellowships

Stanford offers an ACGME-accredited Fellowship in Renal Pathology.

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