表现为间质性肾炎的骨髓瘤肾损伤临床病理特征分析  

Renal injury in myeloma presenting with interstitial nephritis:a clinicopathological analysis

作　　者：刘萌萌[1] 王喜凤[2] 刘兴华[1] 刘鹏[1] 王轶娟[1] 刘灵 魏丽[1] LIU Meng-meng;WANG Xi-feng;LIU Xing-hua(Department of Pathology,the Third People′s Hospital of Zhengzhou,Henan 450000,China)

机构地区：[1]郑州市第三人民医院病理科,河南450000 [2]郑州市第三人民医院肾内科,河南450000

出　　处：《中国临床新医学》2021年第6期586-589,共4页CHINESE JOURNAL OF NEW CLINICAL MEDICINE

摘　　要：目的探讨表现为肾小管间质性炎症的浆细胞骨髓瘤肾损害的临床病理学特征。方法对1例表现为肾小管间质性炎症的浆细胞骨髓瘤的临床表现、组织形态学特征及电镜特点进行分析并复习相关文献。结果34岁男性患者,以急性肾功能不全入院,肾穿刺活检显示为肾小管间质性肾炎,免疫病理显示κ轻链表达,电镜显示肾小球及肾小管基底膜两侧均有泥沙样物沉积。骨髓穿刺活检明确诊断为浆细胞骨髓瘤。结论浆细胞骨髓瘤会引起多器官损害,当以肾功能不全起病时,须结合光镜、免疫病理及电镜全面综合评估,避免漏诊、误诊、误治。Objective To investigate the clinicopathological features of renal injury in plasma cell myeloma(PCM)presenting with tubulointerstitial nephritis.Methods A case of PCM presenting with tubulointerstitial inflammation was reported.The clinical manifestations,histomorphological and electron microscopic features of the case were analyzed and the related literatures were reviewed.Results A 34-year-old male patient was admitted to the hospital with acute renal insufficiency.Renal biopsy showed tubulointerstitial nephritis.Immunopathology showed the expression of kappa light chain.Electron microscopy showed sediment-like deposits on both sides of glomerulus and renal tubular basement membrane.Bone marrow biopsy confirmed the diagnosis of PCM.Conclusion PCM can cause multiple organ damage.When the disease starts with renal insufficiency,it should be comprehensively evaluated by light microscopy,immunopathology and electron microscopy to avoid missed diagnosis,misdiagnosis and mistreatment.

关 键 词：浆细胞骨髓瘤 肾小管间质性肾炎 肾活检 骨髓活检 

分 类 号：R361.2[医药卫生—病理学]