Histopathology and surgical anatomy of patients with primary hyperparathyroidism and calcium phosphate stones
Histopathology and surgical anatomy of patients with primary hyperparathyroidism and calcium phosphate stones
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DOI：
10.1038/ki.2008.161
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发表时间：
2008-07-01
影响因子：
19.6
通讯作者：
Worcester, Elaine M.
中科院分区：
文献类型：
--
作者：
Evan, Andrew E.;Lingeman, James E.;Worcester, Elaine M.
采用术中数码摄影和显微活检相结合的方法，我们测量了5例原发性甲状旁腺功能亢进和大量磷酸钙肾结石患者的肾皮质和乳头状改变。主要的组织改变是可变乳头变平和收缩，贝利尼管扩张，髓内集管和贝利尼管被磷灰石淤塞。两名患者的一些乳头中含有大量兰德尔斑块的大间隙沉积物，在沉积物最丰富的地方，我们发现附着的结石过度生长。因此，这种疾病结合了先前在刷状结石形成中描述的特征——扩张、导管堵塞和乳头状畸形——与常规特发性草酸钙结石形成的间质斑块和结石过度生长的特征，表明这两种模式可以在单个患者中共存。
Using a combination of intra-operative digital photography and micro-biopsy we measured renal cortical and papillary changes in five patients with primary hyperparathyroidism and abundant calcium phosphate kidney stones. Major tissue changes were variable papillary flattening and retraction, dilation of the ducts of Bellini, and plugging with apatite deposits of the inner medullary collecting ducts and ducts of Bellini. Some of the papillae in two of the patients contained plentiful large interstitial deposits of Randall's plaque and where the deposits were most plentiful we found overgrowth of the attached stones. Hence, this disease combines features previously described in brushite stone formers-dilation, plugging of ducts and papillary deformity-with the interstitial plaque and stone overgrowth characteristic of routine idiopathic calcium oxalate stone formers, suggesting that these two patterns can coexist in a single patient.