Atypical cysts, acquired renal cystic disease, and renal cell tumors in end stage dialysis kidneys.
Atypical cysts, acquired renal cystic disease, and renal cell tumors in end stage dialysis kidneys.
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非典型囊肿、获得性肾囊肿病和终末期透析肾脏中的肾细胞肿瘤。
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发表时间：
1980
期刊：
影响因子：
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通讯作者：
J. Mcmanus
中科院分区：
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作者：
M. Hughson;G. Hennigar;J. Mcmanus
在“终末期”透析肾中发现上皮细胞增生和肿瘤。上皮增生在“非典型囊肿”中最明显，其中衬里细胞为多层，偶尔为乳头状。通过多块组织切片和连续组织切片对66例肾功能衰竭患者的肾脏进行了研究。66例中20例为不典型囊肿。9例为实性或囊性肾细胞腺瘤。20例非典型囊肿中6例为腺瘤。肿瘤发生在有非典型囊肿的肾脏中，如从无此类囊肿的肾脏中发现的，其频率高于预期的单独偶然性（P = 0.0106）。肾细胞腺瘤在透析患者中发现的年龄（平均= 41.2岁）比未接受长期透析的尸检和手术病例对照组（平均= 61.8岁）更小。这些观察结果提供了组织学证据，肾细胞肿瘤是容易发展在相对年轻的肾功能衰竭患者，当他们的尿毒症长期透析治疗。研究进一步表明，肿瘤生长的刺激伴随着肾脏的囊性转化。在该系列中的五个病例中，肾脏虽然比正常小得多，但都是多囊性的，与最近认识到的获得性肾囊肿相对应。增生细胞，如在非典型囊肿中观察到的那些，沿囊壁局部沿着。这种形式的上皮增生，常见于非典型囊肿和多囊性透析肾，可能导致肾细胞瘤，据报道，在获得性囊性疾病中发生频率增加。
Hyperplasia and tumors of epithelium are found in "end stage" dialysis kidneys. Epithelial hyperplasia is most conspicuous within "atypical cysts" in which the lining cells are multilayered and occasionally papillary. These features were studied in the kidneys of 66 renal failure patients by means of multiple tissue blocks and serial histologic sections. Atypical cysts were observed in 20 of the 66 cases. Solid or cystic renal cell adenomas were found in nine cases. Six of the cases having adenomas were among the 20 cases having atypical cysts. Tumors occurred in kidneys having atypical cysts, as dintinguished from kidneys without such cysts, with a frequency greater than would be expected to be due to chance alone (P = 0.0106). Renal cell adenomas are found at a younger age in dialysis patients (mean = 41.2 years) than in a control group of autopsies and surgical cases that had not received chronic dialysis (mean = 61.8 years). These observations provide histologic evidence that renal cell neoplasms are prone to develop in relatively young renal failure patients when their uremia is treated by long term dialysis. The studies further indicate that the stimulus for neoplastic growth accompanies a cystic transformation of the kidneys. Kidneys in five cases in the series, although much smaller than normal, were grossly multicystic, corresponding to the recently recognized acquired renal cystic disease. Hyperplastic cells, like those observed in atypical cysts, were present focally along the cyst walls. This form of epithelial hyperplasia, common to both atypical cysts and the multicystic dialysis kidney, may give rise to the renal cell tumors that are reported to occur with increased frequency in acquired cystic disease.