Sirpal Y M
Army Hospital, Delhi Cantt, India.
Indian J Pathol Microbiol. 1995 Oct;38(4):393-7.
Renal transplant dysfunction poses a diagnostic dilemma. Clinical evaluation frequently is inaccurate and needle biopsy carries a significant risk of bleeding. Fine needle aspiration biopsy (FNAB) being an easy to perform, a less traumatic, and rapid technique, was employed in 22 cases of clinically suspected renal allograft rejection. The results were described as nil rejection, mild and severe acute rejection, chronic rejection and cyclosporin nephrotoxicity. Seven of these cases were also needle biopsied. Histology confirmed the cytology findings in all. However, an additional finding of acute vascular episode was observed in a case of chronic rejection. Fine needle aspiration biopsy diagnosis helped in altering the immunosuppressive therapy in 16 graft rejections (excluding 2 cases of irreversible rejection) and 2 cases of cyclosporin toxicity. No rejection was found in 2 cases. Thus, 20 renal grafts could be brought back to normal function. Negligible incidence of complication viz. microscopic haematuria of short duration was noted in only 1 case.
肾移植功能障碍带来了诊断难题。临床评估常常不准确，而穿刺活检有显著的出血风险。细针穿刺抽吸活检（FNAB）操作简便、创伤较小且快速，被应用于22例临床疑似肾移植排斥反应的病例。结果分为无排斥反应、轻度和重度急性排斥反应、慢性排斥反应以及环孢素肾毒性。其中7例病例也进行了穿刺活检。组织学检查证实了所有病例的细胞学检查结果。然而，在1例慢性排斥反应病例中观察到了急性血管事件这一额外发现。细针穿刺抽吸活检诊断有助于改变16例移植排斥反应（不包括2例不可逆排斥反应）和2例环孢素毒性病例的免疫抑制治疗方案。2例病例未发现排斥反应。因此，20个肾移植可恢复正常功能。仅1例病例出现了轻微并发症，即短时间的镜下血尿，发生率可忽略不计。
