【摘要】 目的 :探讨黄色肉芽肿性间质肾炎 (XGIN)的发病机制、病变本质、组织学特点及其对临床的指导意义。方法 :综合分析有关病史与CT、彩超、静脉尿路造影及其余实验资料 ;并同术中发现与病理检验对比分析。结果 :全组病人均于本病发作 4～12年前遭受腰背或腰肋部钝挫伤。各个病人的手术前中后临床诊断皆为“肾癌”而施行根治性手术。“瘤灶”中心位于皮质区并向肾外周“侵袭”。病变局部以大量的泡沫样细胞堆积及间质成片纤维化伴较多的淋巴细胞浸润为主要镜下特征 ,经免疫组化证实为黄色肉芽肿性而非肿瘤性。肾盂肾盏无明显的炎细胞浸润 ;无尿路感染、梗阻或结石的证据。结论 :XGIN可能是创伤后免疫介导的一种迟发性肉芽肿 ;明确其发病机制与病变特点是临床正确诊断与治疗的前题更多还原

【Abstract】 Purpose To investigate the pathogenesis,exact nature and histologic features of xanthogranulomatous interstitial nephritis(XGIN) as well as its clinical significance. Methods The medical histories concerned were collected,with diagnostic image including CT, ultrasonograph, intravenous urograph( IVU) and laboratory data being synthesized by comparison with what was discovered during operations and pathologic assays. Results All patients were ever struck on their loins or backs by blunt violence over 4 years before the onset. Every patient was identified as renal cancer before, during and after operations, and patient underwent radical nephrectomy. Located at cortical parts, the“tumor”foci had penetrated the renal capsules and invaded other organs. However, immunohistochemistry demonstrated that the lesions were not tumors but xanthogranulomas, in that there were stacks of foam cells and lymphocytes with vast extends of fibrotic tissues obliterating the cortical interstitial structures. Urinary tracts did not yield any bacterium, obstruction or calculus. Conclusions XGIN is likely to be a kind of immunologic mediated granuloma following blunt renal trauma, and it is imperative that pathogenesis and character of this lesion be clarified so as to find out any approach to diagnoses and cures of such an unusual kidney disease.更多还原