Glomerular capillary aneurysms in light-chain nephropathy. An ultrastructural proposal of pathogenesis.
Glomerular capillary aneurysms in light-chain nephropathy. An ultrastructural proposal of pathogenesis.
复制标题
轻链肾病中的肾小球毛细血管动脉瘤。
作者：
R. Sinniah;A. Cohen
描述了轻链肾病中肾小球毛细血管动脉瘤的发生和通过电子显微镜确定的发展的形态模式。对4例结节性肾小球疾病患者的肾活检进行了评价。系膜和毛细血管壁上的轻链沉积与毛细血管内单核细胞聚集有关。随后内皮细胞衬里丢失和基底膜系膜锚固点破裂，导致毛细血管动脉瘤样扩张。管壁塌陷，动脉瘤愈合是系膜移位的结果，这一过程与增大的结节相结合，导致管壁增厚、坍塌和管腔变窄。这项研究结合以前发表的报道中的照片，表明肾小球动脉瘤是结节状轻链肾小球病变的共同特征。它还强调了这种肾小球病变和结节性糖尿病肾小球硬化之间的额外的光镜相似之处。
The occurrence of glomerular capillary aneurysms in light-chain nephropathy and a morphologic pattern of development as determined by electron microscopy are described. Renal biopsies from 4 patients with nodular glomerulopathy were evaluated. Light-chain deposition in mesangium and capillary walls was associated with monocyte accumulation in capillaries. Loss of endothelial cell lining and disruption of mesangial anchoring points of basement membranes ensued, resulting in aneurysmal dilatation of the capillaries. The walls collapsed, and the aneurysms healed as a result of mesangial interposition, a process which, in combination with enlarging nodules, led to thickening and collapse of the walls and narrowing of the lumens. This study, in conjunction with review of photographs from previously published reports, indicates that glomerular aneurysms are a common feature of nodular light-chain glomerulopathy. It also emphasizes additional light-microscopic similarities between this glomerulopathy and nodular diabetic glomerulosclerosis.