Gagliano R G, Costanzi J J, Beathard G A, Sarles H E, Bell J D
Am J Med. 1976 Jun;60(7):1026-31. doi: 10.1016/0002-9343(76)90575-1.
The nephrotic syndrome complicating malignancy in the absence of renal vein thrombosis, amyloid or neoplastic infiltration of the kidney is an unusual occurrence. A case of diffuse, well differentiated, lymphocytic lymphoma and lipoid nephrosis documented by light microscopy, electron microscopy and immunofluorescent studies is reported. A review of the literature revealed 76 case reports in which the nephrotic syndrome was associated with neoplasia. The most frequently associated neoplasms are Hodgkin's disease, various carcinomas, nonHodgkin's lymphoma and leukemia in descending order. The most frequent renal lesion in patients with the nephrotic syndrome associated with various carcinomas is membranous glomerulonephritis (81 per cent) as opposed to patients with lymphomas or leukemias who have predominantly lipoid nephrosis (60 per cent). The evidence is reviewed suggesting that the lesions in membranous nephropathy are immunologically mediated by tumor or viral antigen-antibody complexes and in lipoid nephrosis perhaps by a defect in t-lymphocyte function.
肾病综合征合并恶性肿瘤，而无肾静脉血栓形成、淀粉样变性或肿瘤性肾脏浸润，这种情况并不常见。本文报告一例经光镜、电镜及免疫荧光研究证实的弥漫性、高分化淋巴细胞淋巴瘤合并类脂性肾病的病例。文献回顾显示有76例病例报告，其中肾病综合征与肿瘤形成相关。最常相关的肿瘤依次为霍奇金病、各种癌、非霍奇金淋巴瘤和白血病。与各种癌相关的肾病综合征患者中最常见的肾脏病变是膜性肾小球肾炎（81%），而与淋巴瘤或白血病相关的患者主要为类脂性肾病（60%）。文中对相关证据进行了综述，提示膜性肾病的病变可能由肿瘤或病毒抗原-抗体复合物介导免疫反应，而类脂性肾病可能是由于T淋巴细胞功能缺陷所致。
