Bajema I M, Hagen E C, Ferrario F, Waldherr R, Noël L H, Hermans J, van der Woude F J, Bruijn J A
Department of Pathology, Leiden University, The Netherlands.
Clin Nephrol. 1997 Jul;48(1):16-21.
Renal granulomas are a relatively infrequent finding in the kidney biopsy. They have been described in a number of syndromes such as Wegener's granulomatosis, anti-GBM glomerulonephritis, and sarcoidosis, and are commonly believed to be indicative of a fulminant clinical course. In leading textbooks, diverse definitions of renal granulomas are presented, which has led to controversies in identifying them. This, in combination with their rare occurrence, makes it difficult for the general pathologist to identify them. We present the clinical data of 16 patients with renal granulomas, from a total group of 157 patients with systemic vasculitis. Their renal functioning was not significantly different from the other 141 patients in whose renal biopsies renal granulomas were present. Furthermore, we present two practical definitions for the recognition of renal granulomas in the kidney biopsy, and we show a number of examples of their various histopathological shapes.
肾肉芽肿在肾活检中是相对少见的发现。它们已在多种综合征中被描述，如韦格纳肉芽肿病、抗肾小球基底膜肾小球肾炎和结节病，并且通常被认为预示着暴发性临床病程。在主流教科书中，对肾肉芽肿给出了不同的定义，这导致在识别它们时存在争议。再加上其罕见性，使得普通病理学家难以识别它们。我们呈现了16例肾肉芽肿患者的临床资料，这些患者来自总共157例系统性血管炎患者。他们的肾功能与肾活检中未发现肾肉芽肿的其他141例患者没有显著差异。此外，我们给出了在肾活检中识别肾肉芽肿的两个实用定义，并展示了它们各种组织病理学形态的一些实例。
