Schneider B F, Glass W F, Brooks C H, Koenig K G
Department of Radiation Oncology, University of Virginia Health Sciences Center, Charlottesville, USA.
J Intern Med. 1995 Jun;237(6):599-602. doi: 10.1111/j.1365-2796.1995.tb00891.x.
Proteinuria, often nephrotic in range, is a recognized paraneoplastic syndrome of solid tumours, with membranous glomerulonephritis (MGN) the most common histopathological lesion seen on renal biopsy. A 56-year-old male was found to have proteinuria on routine medical examination. History, physical and serological evaluation failed to reveal an aetiology and subsequent renal biopsy showed MGN, presumed to be idiopathic. Prednisone therapy was begun but this proteinuria did not resolve (> 1 g 24 h-1). Eleven months later the patient discovered a testicular mass which was found to be a stage I seminoma upon excision and metastatic evaluation. His proteinuria rapidly normalized after orchectomy and regional lymph node radiotherapy. This is the first known case of MGN associated with testicular seminoma.
蛋白尿通常处于肾病范围,是实体肿瘤公认的副肿瘤综合征,肾活检时最常见的组织病理学病变是膜性肾小球肾炎(MGN)。一名56岁男性在常规体检时发现蛋白尿。病史、体格检查和血清学评估均未发现病因,随后的肾活检显示为MGN,推测为特发性。开始使用泼尼松治疗,但蛋白尿未缓解(>1 g 24 h-1)。11个月后,患者发现睾丸肿块,切除并进行转移评估后发现是I期精原细胞瘤。睾丸切除和区域淋巴结放疗后,他的蛋白尿迅速恢复正常。这是已知首例与睾丸精原细胞瘤相关的MGN病例。