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伴有含肿瘤抗原的肾致密沉积物的恶性黑色素瘤。

Malignant melanoma with renal dense deposits containing tumor antigens.

作者信息

Olson J L, Philips T M, Lewis M G, Solez K

出版信息

Clin Nephrol. 1979 Aug;12(2):74-82.

PMID:393445
Abstract

A patient with disseminated malignant melanoma developed mild renal failure with proteinuria four months following the diagnosis of his neoplasm. Renal biopsy showed a membranoproliferative glomerulonephritis. Electron microscopy revealed intramembranous dense deposits in the glomeruli as well as in tubular basement membranes and Bowman's capsule. Immunofluorescence microscopy demonstrated granular staining for C3 in these same locations and granular deposits of immunoglobulins in the glomerular capillary loops. Light and electron microscopy of the autopsy kidney obtained 5 months later revealed progression of the number, size and density of the deposits. Eluates from both autopsy and biopsy kidney contained melanoma antigen and anti-melanoma antibodies. This case illustrates the association between the dense deposits and neoplasia with the dense deposits representing immune complexes with the tumor as antigen.

摘要

一名播散性恶性黑色素瘤患者在肿瘤诊断四个月后出现轻度肾衰竭伴蛋白尿。肾活检显示为膜增生性肾小球肾炎。电子显微镜检查发现肾小球、肾小管基底膜和鲍曼囊中有膜内致密沉积物。免疫荧光显微镜检查显示这些相同部位有C3颗粒状染色,肾小球毛细血管袢中有免疫球蛋白颗粒状沉积物。五个月后获取的尸检肾脏的光镜和电镜检查显示沉积物的数量、大小和密度有所进展。尸检和活检肾脏的洗脱液中均含有黑色素瘤抗原和抗黑色素瘤抗体。该病例说明了致密沉积物与肿瘤形成之间的关联,致密沉积物代表以肿瘤为抗原的免疫复合物。

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