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非肾源性恶性疾病相关的肾小球肾炎。三例报告并文献复习。

Glomerulonephritis associated with malignant diseases of non-renal origin. A report of three cases and a review of the literature.

作者信息

Wagrowska-Danilewicz M, Danilewicz M

机构信息

Department of Pathomorphology, Medical University, Lódź.

出版信息

Pol J Pathol. 1995;46(3):195-8.

PMID:7496741
Abstract

Glomerular lesions have been reported to occur in association with a wide variety of malignancies, particularly carcinomas and lymphomas. Patients with the neoplastic diseases are exposed to continuous antigenemia, which stimulates antibody production and forms circulating immune complexes. Membranous nephropathy appears to be the most common glomerular lesion in patients with solid tumors, and minimal change glomerulopathy is another major form of glomerular disease associated with lymphomas, particularly with Hodgkin's disease. Three cases of nephropathy associated with anaplastic oat cell bronchial carcinoma, gastric adenocarcinoma and Hodgkin's disease were studied histologically, ultrastructurally and by immunofluorescence. The diagnosis of glomerulopathy preceded the diagnosis of malignant disease. All three patients were admitted to hospital because of nephrotic syndrome. The paraneoplastic glomerulopathies were histologically identical to that of idiopathic membranous glomerulonephritis and minimal change glomerulonephritis. Adult patients over the age of 50-60 with nephrotic syndrome caused by glomerulonephritis, especially by membranous nephropathy, should be screened for cancer.

摘要

据报道,肾小球病变与多种恶性肿瘤相关,尤其是 carcinomas 和淋巴瘤。患有肿瘤性疾病的患者会持续暴露于抗原血症中,这会刺激抗体产生并形成循环免疫复合物。膜性肾病似乎是实体瘤患者中最常见的肾小球病变,而微小病变性肾小球病是与淋巴瘤,尤其是霍奇金病相关的另一种主要的肾小球疾病形式。对 3 例与间变性燕麦细胞支气管癌、胃腺癌和霍奇金病相关的肾病患者进行了组织学、超微结构和免疫荧光研究。肾小球病的诊断先于恶性疾病的诊断。所有 3 例患者均因肾病综合征入院。副肿瘤性肾小球病在组织学上与特发性膜性肾小球肾炎和微小病变性肾小球肾炎相同。50 - 60 岁以上因肾小球肾炎,尤其是膜性肾病导致肾病综合征的成年患者,应进行癌症筛查。

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