Laberke H G
Pathol Res Pract. 1987 Jun;182(3):368-80. doi: 10.1016/S0344-0338(87)80073-0.
In addition to confirming the established light microscopic findings, electron microscopic assessment of renal tissue with pyelointerstitial reflux damage also provides other important information. Isolated tubular epithelial cells and small tubular epithelial cell complexes, the earliest formative phase of thyroid-like lesions, were observed after subtotal tubular destruction. Moreover, secretory granule-like structures, identified by immunohistologic methods as renin granules, were found in tubular epithelium, apparently atrophic and cell-rich glomeruli, and walls of tortuous arterioles. Various stages of glomerular scarring were documented in the early phase of glomerular destruction and electron-dense material (IgM) was identified. Electron microscopy plays an important role in differentiating thin-walled vessels (lymphatic vessels, capillaries, venules). While the presented findings are characteristic for reflux nephropathy, they are not pathognomonic: they also occur, for example, in urinary tract obstructions without reflux mechanism.
除了证实已有的光学显微镜检查结果外，对伴有肾盂间质反流损伤的肾组织进行电子显微镜评估还能提供其他重要信息。在肾小管大部分破坏后，观察到孤立的肾小管上皮细胞和小的肾小管上皮细胞复合体，这是甲状腺样病变的最早形成阶段。此外，通过免疫组织学方法鉴定为肾素颗粒的分泌颗粒样结构，可见于肾小管上皮、明显萎缩且细胞丰富的肾小球以及迂曲小动脉壁。在肾小球破坏的早期记录到了肾小球瘢痕形成的各个阶段，并鉴定出电子致密物质（IgM）。电子显微镜在鉴别薄壁血管（淋巴管、毛细血管、小静脉）方面起着重要作用。虽然所呈现的发现是反流性肾病的特征，但并非特异性的：例如，它们也会出现在无反流机制的尿路梗阻中。
