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血液透析引起囊性变发展为肾细胞癌

血液透析引起囊性变发展为肾细胞癌

图示:肾细胞癌,发生于血液透析引起的囊性变的肾脏。多种原因引起的终末期肾病人由于长期透析在肾皮质和(或)肾髓质形成了0.5至2cm的囊。终末期肾体积缩小,但是囊性变的形成使其体积回复到正常大小或轻度增大,然而没有达到显性遗传性多囊肾(DPKD)的大小。象DPKD,与透析相关的囊性变的囊可见草酸盐结晶和出血。约有一半慢性血液透析病人几年后将形成一定程度的囊性变,1%-5%的将发展为肾细胞癌。

This is a renal cell carcinoma arising in a kidney with dialysis-induced cystic change. Patients with end stage renal disease from any cause who have undergone prolonged dialysis may develop 0.5 to 2 cm cysts in the medulla and/or cortex. Since end stage kidneys are small, the development of cystic change enlarges them back to normal size or slightly greater. Thus, they do not reach the size of kidneys with dominant polycystic kidney disease (DPKD). Like DPKD, the cysts in dialysis-associated cystic change often contain oxalate crystals or hemorrhage. About half of chronic hemodialysis patients will have some cystic renal change after several years, and between 1 and 5% will develop renal cell carcinoma.


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