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The Society for Ultrastructural Pathology (SUP) is a nonprofit international organization of electron microscopists whose interest and purpose are to examine and disseminate information on the fine structure (micro- and nanometer level) of cells and tissues. Formed in 1986, the Society fosters the application of electron microscopy in the diagnosis and research of diseases, and its meetings are an opportunity for the exchange of ultrastructural and immunohistochemical information relevant to diagnostic pathology. The academic objectives of the Society are accomplished at its biennial international meeting, UltraPath, as well as through its journal, Ultrastructural Pathology. The SUP is also a Companion Society of the United States and Canadian Academy of Pathology (USCAP), and holds a Companion Meeting in conjunction with each yearly USCAP meeting. Membership is open to anyone with an interest in or desire to learn about cell architecture at the fine structural level; please see the membership page.

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The President Discusses EM with The Ultrastructure Culture Vulture

My objective on this forum is to provide a regular commentary on aspects of ultrastructural pathology to generate discussion among our members so we can learn from each other. As electron microscopists, we are incredibly privileged to ‘see the unseen’. With this comes great responsibility because the findings of our ultrastructural examinations have the potential to alter diagnoses and patient management. At each examination, I am joined by my imaginary colleague, The Ultrastructure Culture Vulture, who is somewhat of a contrarian. ‘The Vulture’ reminds me to approach each investigation with an ‘open view’ and challenge the working diagnosis that is typically constructed upon clinical information, light microscopy findings and immune-based tests. As electron microscopists, we must consider whether the ultrastructure is consistent with the working diagnosis – or is there more information in the biopsy that is only detectable at the ultrastructural level? I’m sure we can all recall cases with surprising EM results. To illustrate this point, I draw your attention to the paper ‘Alport Syndrome Classification & Management’ by Warady et al (2020). The authors state, “evidence suggests that a sizeable fraction of patients with otherwise uncharacterized chronic kidney disease or those with focal segmental glomerulosclerosis (FSGS) diagnosed based on histology have genetic abnormalities in type IV collagen”. Hence, when examining cases of suspected FSGS, I am reminded by ‘The Vulture’ to not only look for podocyte changes consistent with FSGS but also glomerular basement membrane changes that may indicate an underlying type IV collagen gene mutation.

So please join me in our ‘Members Only’ section for more discussion!

John Brealey

President

Society for Ultrastructural Pathology

Vulture Alert!

Dr Mark Koina recently spotted ‘The Vulture’ in his lab in Canberra, Australia. The rumour is ‘The Vulture’ is coming to Sydney for UltraPath XXI but has become lost!