Kryvenko Oleksandr N, Haley Susan L, Smith Steven C, Shen Steven S, Paluru Swetha, Gupta Nilesh S, Jorda Merce, Epstein Jonathan I, Amin Mahul B, Truong Luan D
Department of Pathology, University of Miami, Miami, FL, USA; Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA; Department of Pathology, Henry Ford Hospital, Detroit, MI, USA.
Histopathology. 2014 Sep;65(3):309-18. doi: 10.1111/his.12394. Epub 2014 May 29.
The study of haemangiomas in end-stage renal disease (ESRD).
Twenty ESRD nephrectomies from 16 patients (aged 9 months-68 years) were due to hypertension (four), focal segmental glomerulosclerosis (four), lupus nephritis (three), diabetes (one), IgA nephropathy (one), hereditary nephritis (one), congenital nephrotic syndrome (one) and unknown cause (one). Haemangiomas appeared as a single mass (15), two masses (one), three masses (one), four masses (two) and eight masses (one) per kidney. Tumours measured 0.2-3.5 cm. Four patients had bilateral haemangiomas. All tumours were in the medulla and often abutted renal sinus fat. All except one of the tumours were anastomosing haemangiomas, showing isolated or interconnected sinusoidal capillary-sized vascular channels lined by a single layer of benign cuboidal CD34(+) , CD31(+) , D2-40(-) endothelial cells, separated by loose stroma with spindle cells. One tumour was a cellular capillary haemangioma. Intravascular growth was seen in nine specimens. All haemangiomas had extramedullary haematopoiesis. Acquired cystic kidney disease (ACKD) was seen in 11 kidneys (nine patients), renal cell carcinoma (RCC) in five, ACKD-associated RCC precursors in three, Wilms' tumour in one and papillary adenomas in five.
Anastomosing haemangioma appears as a distinctive clinicopathological entity developing in kidneys with ESRD, with or without ACKD.
研究终末期肾病（ESRD）中的血管瘤。
16例患者（年龄9个月至68岁）的20例ESRD肾切除术病因如下：高血压（4例）、局灶节段性肾小球硬化（4例）、狼疮性肾炎（3例）、糖尿病（1例）、IgA肾病（1例）、遗传性肾炎（1例）、先天性肾病综合征（1例）及病因不明（1例）。血管瘤表现为每个肾脏单个肿块（15例）、两个肿块（1例）、三个肿块（1例）、四个肿块（2例）和八个肿块（1例）。肿瘤大小为0.2 - 3.5厘米。4例患者有双侧血管瘤。所有肿瘤均位于髓质，常毗邻肾窦脂肪。除1例肿瘤外，其余均为吻合性血管瘤，表现为孤立或相互连接的窦状毛细血管大小的血管通道，内衬单层良性立方形CD34(+)、CD31(+)、D2 - 40(-)内皮细胞，由含有梭形细胞的疏松间质分隔。1例肿瘤为细胞性毛细血管瘤。9个标本中可见血管内生长。所有血管瘤均有髓外造血。11个肾脏（9例患者）出现获得性囊性肾病（ACKD），5例出现肾细胞癌（RCC），3例出现ACKD相关的RCC前驱病变，1例出现肾母细胞瘤，5例出现乳头状腺瘤。
吻合性血管瘤表现为一种在ESRD肾脏中发生的独特临床病理实体，无论有无ACKD。
