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[肾移植患者膀胱的肾源性化生]

[Nephrogenic metaplasia of the bladder in renal transplant patients].

作者信息

Buzelin F, Hourmant M Y, Audoin A F, Karam G, Philippot D

机构信息

Laboratoire d'Anatomie Pathologique, C.H.U., Nantes.

出版信息

J Urol (Paris). 1988;94(7):323-7.

PMID:3065414
Abstract

Nephrogenic metaplasia of the bladder is rare; less than one hundred cases have been reported. Four personal cases and 16 cases reported in the literature concerning renal transplant patients demonstrate that the frequency of this disease is much higher in this group than in the general population. The symptoms and signs, age of onset, macroscopic and microscopic appearance of the lesions correspond to the description in non-transplant patients, apart from the preferential site adjacent to the reimplanted ureter and the presence, in two cases, of cells with virus-like inclusions, one of which corresponded to CMV infection. The traumatic factor in these patients is not sufficient on its own to explain the relative frequency of this lesion in renal transplant patients. The role of immunosuppression, resulting in a reduction of "immunological surveillance", is possible; this metaplasia usually has a benign course, but this high risk population must be carefully monitored for the development of this lesion.

摘要

膀胱肾源性化生罕见,报告病例少于100例。本人的4例及文献报道的16例肾移植患者病例表明,该疾病在这组患者中的发生率远高于普通人群。除了病变好发于再植输尿管附近,以及2例出现具有病毒样包涵体的细胞(其中1例为巨细胞病毒感染)外,其症状、体征、发病年龄、病变的大体及显微镜表现与非移植患者的描述相符。这些患者中的创伤因素本身不足以解释肾移植患者中该病变的相对发生率。免疫抑制导致“免疫监视”功能降低可能起到了作用;这种化生通常病程良性,但必须对这一高危人群仔细监测该病变的发展情况。

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