What can the microstructure of stones tell us?

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• 作者：James C. Williams Jr. ; Elaine Worcester ; James E. Lingeman
• 关键词：Nephrolithiasis ; Imaging
• 刊名：Urolithiasis
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：45
• 期：1
• 页码：19-25
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Urology; Nephrology; Medical Biochemistry;
• 出版者：Springer Berlin Heidelberg
• ISSN：2194-7236
• 卷排序：45

文摘

How stones are retained within the kidney while small in size is still not fully understood. In this paper, we show two examples of how stones are retained during early growth: one is growth on Randall’s (interstitial) plaque, and the other is growth on mineral that has formed as a luminal plug in a terminal collecting duct. These two mechanisms of stone retention during early growth have distinctive morphologic features that can be seen by methods that show the microscopic structure of the stones. Stones growing on Randall’s plaque display an apatite region that is typically not large in size (<0.5 mm across) but which usually shows luminal spaces, which are signs of its origin in the connective tissue of the papilla. Stones growing on ductal plugs also show attachment to a piece of apatite, but the apatite regions are typically larger (often >1 mm long and >0.5 mm wide), and they are solid, without spaces running through them. We propose that knowing the mechanisms of stone retention during early stone formation could allow for better treatment of stone diseases.