Additional Value of Second Harmonic Generation Microscopy in the Diagnosis of Feline Collagen Type III Glomerulopathy

A 1.5-year-old neutered female Domestic Shorthair cat was euthanized after the diagnosis of end-stage protein-losing nephropathy associated with the onset of nephrotic syndrome. At necropsy, both kidneys were diffusely pale and swollen with a granular cortex. Histologically, glomeruli had diffuse global mesangial and capillary wall expansion by homogeneous pale eosinophilic material. This material was Congo red negative, blue with Masson's trichrome stain, weakly positive with periodic acid-Schiff stain, bright red with Picrosirius red and birefringent under polarized light. Transmission electron microscopy and second harmonic generation (SHG) microscopy revealed mesangial and subendothelial collagen fibril deposition. Type III collagen deposition was confirmed by immunohistochemistry. This study provides an original and complete description of feline collagen type III glomerulopathy and emphasizes the possibility of directly diagnosing glomerular collagen deposition on unstained slides through SHG microscopy.

Diagnosis of Collagen Type III Glomerulopathy Using Picrosirius Red and PASH/Masson's Trichrome Stain

Canine collagen type III glomerulopathy (Col3GP) is a rare juvenile nephropathy in which irregular type III collagen fibrils and fibronectin accumulate in glomerular capillary walls and the mesangium. Necropsy findings were reviewed from 5 puppies diagnosed with Col3GP at 6 to 18 weeks of age. Histologically, with hematoxylin and eosin stain, the glomerular capillary walls and mesangium were diffusely and globally expanded by homogeneous pale eosinophilic material. Ultrastructurally, the subendothelial zone and mesangium were expanded by fibronectin and cross-banded collagen type III fibrils, diagnostic of Col3GP. Two additional stains were employed to identify the material within glomeruli as fibrillar collagen using light microscopy. In all 5 cases, the material was red with picrosirius red and birefringent under polarized light, and was blue with periodic acid-Schiff/hematoxylin/trichrome (PASH/TRI), thereby identifying it as fibrillar collagen. Based on these unique staining characteristics with picrosirius red and PASH/TRI, Col3GP may be reliably diagnosed with light microscopy alone.