| 图片： | |
|---|---|
| 名称： | |
| 描述： | |
- 移植肾穿刺病例
This allograft shows severe interstitial fibrosis and tubular atrophy, previously called chronic allograft nephropathy (CAN). Now the term CAN is abandoned. In addition, there is diffuse interstitial mononuclear infiltration (i3) and tubulitis (t1, or t2?) So based on these findings, it is to warrant a diagnosis of borderline changes or Banff type 1A rejection. However, due to the severe chronic changes, the clinician is most likely to give up.
Some glomeruli appear segmentally sclerotic. My feeling is that it is non-specific scarring. Of course, correlation with clinical situation (such as proteinuria or not) is necessary.
-
These new photos suggest chronic transplant glomerulopathy and maybe intimal arteritis (v1). Though acute T-cell-mediated rejection, Banff type 2A is supposed to respond to the bolus adminstration of the steroids, there is too much chronic change. I am not surprised that this patient is not responding. The bolus adminstration of steroids is a nice try. Now it is time to give up.
-
本帖最后由 于 2010-01-29 15:18:00 编辑
我的病理报告：
１ 急性肾小管坏死（acute tubular mecrosis，ATN）；
２ 疑为急性排斥反应（suspicious of acute rejection, Banff05 Schema, i1,t1,v0,g0,）；
3 慢性活动性T细胞介导性排斥反应chronic allograft activity T cell-mediated rejection, Banff2005 Schema,ci3,ct3,cg3,cv3,ah3,mm2）
（ Banff 2005移植肾活检诊断标准）
