糸球体病変の活動度よりみた腎生検病理組織像の分類

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In 1951, Iversen and Brun had first introduced the technique of the renal needle biopsy. In past twenty years, this method have proved to be valuable to diagnose of the renal diseases and to forecast a steroid effect on the patients with nephrotic syndrome. Moreover, we considered that a histological diagnosis should be extended its usefulness to determining the activity of renal lesions and forecasting a prognosis of the patient. The present study was aimed to classify the pathological change of glomerulonephritis from the standpoint of the activity of glomerular lesions obtained by needle biopsy. Materials and Methods Studies were performed on 36 inpatients with glomerulonephritis of the First Department of Internal Medicine of Osaka University Hospital. The specimens were obtained by a percutaneous needle biopsy. These cases were consisted of 27 males and 9 females and their age was among 15 years-old to 51 years-old. The material was fixed with 10% formalde-hyde, then Hematoxylin-Eosin staining and Periodic-Acid-Schiff staining were applied. Diagnostic criteria of the histological activity of glomerular lesions The table shows our classification of histological diagnosis of glomerulonephritis from the standpoint of the activity of glomerular lesions. This classification was derivered from Prof. Ishikawa (see reference N0.4) and modified by authors' concept. Type A: There is usually no adhesion between the Bowman's capsule and the glomerular tuft. Type B: There is adhesion between the Bowman's capsule and the glomerular tuft. Type C: There is adhesion between the Bowman's capsule and the glomerular tuft, and marked hyalinization of the intraglomerular tuft can be seen. Each type is further classified three forms, these are, active, intermediate and repaired. An active form shows mesangeal and endothelial proliferation (mitosis and poikilocytosis in mesangeal nuclei). Polynucleocyte infiltration and fibrin exudation in the glomerular lesions. Mesangeal changes are considered as the most important. An intermediate form shows no remarkable active finding, especially in mesangium. A repaired form shows axial thickening, organization or hyalinization. Concerning the glomerular lesion of nephrotic type of glomerulonephritis, the classification introduced by Prof. Kinoshita was adopted, and about the clinical classification of glomerulonephritis, Prof. Ohshima's one was adopted. (see reference No. 6-8)
社団法人日本循環器学会の論文
1973-05-20

糸球体病変の活動度よりみた腎生検病理組織像の分類

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