2004-7-23-16498-Ch09urinaryDis╲╲病理学课件.ppt

Disease of the urinary system Tian Dong Ping（田东萍 教授) 汕头大学医学院病理学教研室 2003年5月 Section 1 Introduction A. Anatomy of kidney Cut surface of kidney Cortex Medullary Renal papilla Calyx Renal pelvis B. Histology of kidney Nephrons: include glomerulus and renal tubulus. Glomerulus: Bowman’s capsule and capillary tuft. C. Ultrastructure of glomerulus 1. Glomerular filtration barrier: basement membrane (B. M) endothelial cell Visceral epithelial cell (podocyte), foot-process have plenty negative ion substances (heparan etc) 2. Glomerular mesangium structure mesangial cell mesangial matrix D. Classification of urinary system disease 1. Glomerulonephritis 2. Pyelonephritis 3. Tumor of kidney 4. Tumor of bladder Section 2 Glomerulonephritis (GN) A. Definition Glomerulonephritis is a hypersensitivity inflammatory diease. It cause by various immune complex and eppear diffuse glomeruli proliferative inflammation in bilateral kidney B. Etiology and Pathogenesis 1. Antigen Endogenous antigen GBM, endothelial cell, mesangial cell Exogenous antigen bacteric, virus, fungus, parasit, drug ect 2. Immune complex (1) In site immune complex 10% Antibodies react directly with, intrinsic tissue antigen (GBM) or antigen planted planted (noglomerular antigen) Immunofluorescent (IF) appear linear pattern or granular pattern . (2) Circulating immune complex 90% The antigen and antibody have not immunologic specificity for glomerular constituents, antigen-antibody complex are formed in the circulation and then deposit in the glomeruli. IF appear granular pattern. 3. Pathogenesis C. Classification and pathological-clinical character Ⅰ. Acute diffuse proliferative GN 急性弥漫性增生性肾小球肾炎 （endocapillary proliferative GN, poststreptococcus GN) 1. Pathology Grossly: “big and red kidney” “flea-bitten kidney” 1. Pathology LM: All the glomerule are enlarge, and filled with nuclei