(精选)【医学课件课件】继发性肾小球肾炎教学课件.pptVIP

CONCLUSION Pyelonephritis: is a suppurative inflammation, is caused by infection of suppurative bacterium. The pelvis, interstitium and tubules is major injury site. Morphology:focal suppurative inflammation (phlegmonous inflammation or abscesses). Its clinical manifestations include: fever, malaise, flank pain, dysuria,frequency and urgency, pyuria and white cell casts. 五、过敏性间质性肾炎( allergic interstitial nephritis ) 概念： 各种过敏因素导致的非化脓性炎症，主要侵犯肾间质,主要的临床症状是肾功能损伤乃至肾功能衰竭。 病因发病机制：药物和其他过敏原导致IV型变态反应 病理变化： 急性过敏性间质性肾炎:双肾肾间质弥 漫性水肿，淋巴、单核及多少不等的嗜 酸性白细胞浸润，肾小管上皮细胞变性 慢性过敏性间质性肾炎:双肾肾间质淋 巴和单核细胞浸润，纤维化，肾小管弥 漫萎缩。 临床病理联系：肾间质弥漫性病变导致 肾小管弥漫性损伤，严重损伤肾功能。 CONCLUSION Allergic interstitial nephritis: is a nonsuppurative inflammation, is caused by drug allergy. The interstitium and tubules is major injury site. Morphology: mononuclear cells (lymphocytes and mono-phagocytes) and/or eosinocytes diffuse infiltrate in interstitium of both kidneys, so often occur acute renal failure. KEY WORD: Pyelonephritis, Allergic interstitial nephritis 六、肾脏肿瘤 (1) 肾细胞癌( renal cell carcinoma ) 组织发生：近端肾小管上皮细胞 病理特点：位于肾皮质,切面黄色;富含透明胞浆的癌细胞呈巢索状排列。 生物性特性：中老年好发；因血管丰富，可早期血行转移至肺、骨。 CONCLUSION Renal cell carcinoma: Histogenesis: proximal tubular cells. Morphology: clear-cancerous cells and trabecularism. Clinical features: renal neoplasm and hematuria occur in 60th and 70th decades of men. Behavior: malignant tumor, often hematogenous metastasis. (2) 肾母细胞瘤 ( nephroblastoma, Wilm tumor ) 组织发生:肾胚芽组织 病理特点:肾内巨大肉瘤样肿块;由未分化的胚芽组织、间胚叶性间质和幼稚的肾小球和肾小管组成 生物学特性:婴幼儿好发;早期血行转移至肺、肝等 CONCLUSION Nephroblastoma (Wilm’s tumor): Histogenesis: renal blastem. Morphology: blastem tissue, abortive glomeruli and tubules, mesenchymal tissue. Clinical features: renal neoplasm and hematuria occur in 2-4 years childhood. Behavior: malignant tumor, often hematogenous metastasis. 继发性肾小球肾炎 IgA肾病或肾小球肾炎 病因发病机制：粘膜损伤→ IgA形成 →含IgA的大分子的免疫复合物沉积于肾小球 病变特点： 免疫病理：以IgA为主的免疫球蛋白和C3沉积于系膜区。 光学显微镜：局灶性或弥漫性的，除膜性肾小球肾炎以外的各型肾小球肾炎。 临床表现：可出现血管炎和紫癜及各型肾炎综合征。 各型GN的