11 Malaysian J Pathol 2009; 31(1) : 11 – 16 Historical development of the renal histopathology services in Malaysia Lai-Meng LOOI MD, FRCPath and Phaik-Leng CHEAH MD, FRCPath Department of Pathology, Faculty of Medicine, University of Malaya Abstract Western-style medicine was introduced to Malaya by the Portuguese, Dutch and British between the 1500s and 1800s. Although the earliest pathology laboratories were developed within hospitals towards the end of the 19th Century, histopathology emerged much later than the biochemistry and bacteriology services. The University Departments of Pathology were the pioneers of the renal histopathology diagnostic services. The Department of Pathology, University of Malaya (UM) received its irst renal biopsy on 19 May 1968. Hospital Universiti Kebangsaan Malaysia (HUKM) and Hospital Universiti Sains Malaysia (HUSM) started their services in 1979 and 1987 respectively. It is notable that the early services in these University centres caterred for both the university hospitals and the Ministry of Health (MOH) until the mid-1990s when MOH began to develop its own services, pivoted on renal pathologists trained through Fellowship programmes. Currently, key centres in the MOH are Kuala Lumpur Hospital, Sultanah Aminah Hospital Johor Bahru and Malacca Hospital. With the inclusion of renal biopsy interpretation in the Master of Pathology programmes, basic renal histopathology services became widely available throughout the country from 2000. This subsequently iltered out to the private sector as more histopatholo- gists embraced private practice. There is now active continuing professional development in renal histopathology through clinicopathological dicussions, seminars and workshops. Renal research on amyloid nephropathy, minimal change disease, IgA nephropathy, ibrillary glomerulonephritis, lupus nephritis and microwave technology have provided an insight into the patterns of renal pathology and changing criteria for biopsy. More recently, there has been increasing involvement of renal teams in clinical trials, particularly for lupus nephritis and renal transplant modulation. Keywords: renal biopsy, renal pathology, history of pathology Address for correspondence and reprint requests: Professor L.M. Looi, Department of Pathology, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. Email: looilm@ummc.edu.my SPECIAL ARTICLE INTRODUCTION Ancient Greek and Roman civilisations have long recognised the existence of diseases which affected efluvia from the body. With the inlux of science into the art of medical practice from the 8th to 12th Century AD, Arabic practitioners began to introduce examination of the urine for colour, sediment, smell and taste to guide diagnosis and prognostication of disease. However, it was not until the 1800s, that the pioneering work of Rokitansky and Virchow drove home the concept of organ-based structural and cellular pathology. The classic reports by Richard Bright (1789-1855) from Guy’s Hospital, London, linking the clinical manifestations of renal disease to morphological changes in the kidneys can be regarded as one of the most important landmarks in the development of renal pathology. 1 Bright’s observations were based on autopsy material, and thus suffered limitations in appreciating renal changes during life and serial changes during disease progression. The advent of the percutaneous renal biopsy in the 1950s, 2 together with developments in immunology and invention of the electron microscope, changed the scope and practice of renal histopathology entirely. From then, classiication schemes, management, monitoring and therapeutic options for renal disease took on a clinicopathological basis. Modern-day renal histopathology service is strongly based on recognising histomorphological, immunohistopathological