Rigatti P, Colombo R, Centemero A, Francesca F, Di Girolamo V, Montorsi F, Trabucchi E
Department of Urology, Scientific Institute, San Raffaele, Italy.
Eur Urol. 1989;16(3):207-11. doi: 10.1159/000471571.
Biopsy material taken from kidneys of 14 patients with renal stones before performing extracorporeal shock wave lithotripsy (ESWL) and an average of 15 days after was examined histologically and ultrastructurally. In the post-ESWL specimens, light microscopy revealed edema and extravasation of urine and blood into the interstitial spaces, blocking of cortical tubules by hemorrhagic streaks and widespread dilatation of the veins, with signs of endothelial destruction and partial organization of thrombi. By using the electron microscope, abnormalities of the endothelium and glomerular epithelium, hemosiderin accumulations in the tubular cells and small linear patches of fibrosis at the corticomedullary junction and in the cortical interstitial spaces were seen. This preliminary report indicates that renal damage can be shown soon after ESWL on histological and ultrastructural studies and that the lesions observed can be either reversible or permanent.
对14例肾结石患者在进行体外冲击波碎石术（ESWL）之前及平均术后15天取自肾脏的活检材料进行了组织学和超微结构检查。在ESWL术后的标本中，光学显微镜检查显示有水肿，尿液和血液渗入间质间隙，皮质肾小管被出血条纹阻塞，静脉广泛扩张，伴有内皮细胞破坏和血栓部分机化的迹象。通过电子显微镜观察到内皮细胞和肾小球上皮细胞异常，肾小管细胞中有含铁血黄素沉积，在皮质髓质交界处和皮质间质间隙有小的线性纤维化斑块。这份初步报告表明，在ESWL术后不久，组织学和超微结构研究就能显示出肾脏损伤，且观察到的病变可能是可逆的，也可能是永久性的。
