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中华肾病研究电子杂志 ›› 2023, Vol. 12 ›› Issue (05) : 297 -299. doi: 10.3877/cma.j.issn.2095-3216.2023.05.012

病例报告

慢性淋巴细胞白血病肾间质浸润一例并文献复习
姚理京, 陈幸()   
  1. 361003 厦门大学附属第一医院肾内科、福建省慢性肾小球疾病临床医学研究中心
  • 收稿日期:2022-06-21 出版日期:2023-10-28
  • 通信作者: 陈幸

Leukemic renal interstitial infiltration in chronic lymphocytic leukemia: a case report and literature review

Lijing Yao, Xing Chen()   

  • Received:2022-06-21 Published:2023-10-28
  • Corresponding author: Xing Chen
引用本文:

姚理京, 陈幸. 慢性淋巴细胞白血病肾间质浸润一例并文献复习[J/OL]. 中华肾病研究电子杂志, 2023, 12(05): 297-299.

Lijing Yao, Xing Chen. Leukemic renal interstitial infiltration in chronic lymphocytic leukemia: a case report and literature review[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2023, 12(05): 297-299.

慢性淋巴细胞白血病(chronic lymphocytic leukemia,CLL)是一种单克隆小淋巴细胞疾病,在我国较为少见,更少见肾脏受累。本文报道1例老年男性慢性淋巴细胞白血病浸润肾脏导致急性肾衰竭而行血液透析治疗的病例,此患者同时存在免疫球蛋白重链(immunoglobulin heavy chain, IGH)基因V区、免疫球蛋白轻链κ链(immunoglobulin light chain κ chain, IGK)基因及免疫球蛋白轻链λ链(immunoglobulin light chain λ chain, IGL)基因单克隆重排,提示为双克隆慢性淋巴细胞白血病。

图1 肾脏穿刺活检光镜结果注:A:光镜下可见数个肾小球鲍曼氏囊及较多肾小管被淋巴细样细胞包绕和浸润(HE×40);B:部分肾小球毛细血管袢开放尚好,可见少量浸润细胞(HE×200);C:节段肾小球系膜区系膜细胞和基质轻度增生(PAS×100);D:部分肾小管管腔扩张,刷状缘消失,裸基底膜形成,多处肾小管不完整,浸润细胞毁损(PAS×200)
图2 肾脏穿刺活检电镜结果注:A:电镜×6 000,足突节段性融合(<30%);B:电镜×2 500,肾间质见大量浸润细胞
图3 患者随访数据
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