Evan Andrew E, Lingeman James E, Coe Fredric L, Miller Nicole L, Bledsoe Sharon B, Sommer Andre J, Williams James C, Shao Youzhi, Worcester Elaine M
Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, Indiana 46223, USA.
Kidney Int. 2008 Jul;74(2):223-9. doi: 10.1038/ki.2008.161. Epub 2008 Apr 30.
Using a combination of intra-operative digital photography and micro-biopsy we measured renal cortical and papillary changes in five patients with primary hyperparathyroidism and abundant calcium phosphate kidney stones. Major tissue changes were variable papillary flattening and retraction, dilation of the ducts of Bellini, and plugging with apatite deposits of the inner medullary collecting ducts and ducts of Bellini. Some of the papillae in two of the patients contained plentiful large interstitial deposits of Randall's plaque and where the deposits were most plentiful we found overgrowth of the attached stones. Hence, this disease combines features previously described in brushite stone formers--dilation, plugging of ducts and papillary deformity--with the interstitial plaque and stone overgrowth characteristic of routine idiopathic calcium oxalate stone formers, suggesting that these two patterns can coexist in a single patient.
我们采用术中数字摄影和微量活检相结合的方法，对5例原发性甲状旁腺功能亢进且患有大量磷酸钙肾结石的患者的肾皮质和乳头变化进行了测量。主要组织变化包括乳头不同程度的扁平、回缩，乳头管扩张，以及内髓集合管和乳头管被磷灰石沉积物堵塞。两名患者的一些乳头含有大量兰德尔斑的间质沉积物，在沉积物最多的地方，我们发现附着的结石过度生长。因此，这种疾病兼具先前在透钙磷石结石患者中所描述的特征——导管扩张、堵塞和乳头畸形——以及常规特发性草酸钙结石患者的间质斑块和结石过度生长的特征，这表明这两种模式可在同一患者中共存。
