Laberke H G, Klingebiel T, Quack G
Pathol Res Pract. 1983 Mar;176(2-4):284-96. doi: 10.1016/S0344-0338(83)80018-1.
The morphological variations of thyroid-like lesions in the kidney in 15 cases with chronic destructive interstitial nephritis as the basic alteration were examined with light microscopy and immunohistological methods. Reflux pyelonephritis was present in some cases. Thyroid-like lesions can develop at any age. "Mature" thyroid-like lesions possess large follicular structures and solid tubular epithelial cell complexes, whereas the follicular structures in "young" thyroid-like lesions are small. The hyaline casts are Tamm-Horsfall protein positive in between one- and two-thirds of the follicles. IgA is present in all follicular lumina. The thyroid-like lesions are the result of a regenerative process. They develop after subtotal parenchymal destruction of remaining tubular epithelial cells from the ascending limb of the loop of Henle, the distal convoluted tubules and the collecting ducts. They are pathognomonic for healed destructive bacterial interstitial nephritis, but can also be observed in analgesic nephropathy, hydronephrosis, and nephronophthisis when these basic diseases are preceded by pyelonephritis.
对15例以慢性破坏性间质性肾炎为基本病变的肾内甲状腺样病变进行了光镜和免疫组织学检查。部分病例存在反流性肾盂肾炎。甲状腺样病变可在任何年龄发生。“成熟”的甲状腺样病变具有大的滤泡结构和实性管状上皮细胞复合体，而“年轻”甲状腺样病变中的滤泡结构较小。在三分之一至三分之二的滤泡之间，透明管型Tamm-Horsfall蛋白呈阳性。所有滤泡腔内均有IgA。甲状腺样病变是再生过程的结果。它们在亨氏袢升支、远曲小管和集合管的剩余管状上皮细胞实质大部分破坏后形成。它们是愈合的破坏性细菌性间质性肾炎的特征性表现，但当镇痛剂肾病、肾积水和肾单位肾痨等基础疾病之前有肾盂肾炎时也可观察到。
