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Tubular Epithelial Vacuolar Change
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Tubular Epithelial Vacuolar Change

Electron micrograph of proximal tubular epithelial cells showing cytoplasmic membrane bound vacuoles.
Substances in the lumen (L) can be reabsorped into tubular cells by pinocytotic vesicles which can then fuse with endogenous lysosomes to produce large membrane bound vacuoles.
Note the apical brush border or microvilli (Mv).
Tubular basement membrane (TBM).
(Description By:H. Yamase, M.D. )
(Image Contrib. by:H. Yamase, M.D. UCHC )
Tubular vacuolar change
Etiology

Hypokalemia.
Uncontrolled diabetes mellitus.
Mannitol administration.
Intravenous pyelography (contrast induced).
Pathogenesis

Various substances in the tubular lumina can be reabsorbed into tubular cells by pinocytotic vesicles which can then fuse with endogenous lysozomes to produce large membrane bound vacuoles.
Vacuolar change of tubular cells is a reversible condition.,
Epidemiology

The epidemiology is diverse.
Vacuolar change is a non-specific cellular change.
General Gross Description

There are no specific gross abnormalities.
The finding is microscopic.
General Microscopic Description

The epithelial cells of the proximal tubules show marked cytoplasmic vacuolization.
Clinical Correlation

Patients may manifest signs, symptoms and clinical laboratory values of acute renal failure.
References

Renal Disease Classification and Atlas of Tubulo-Interstitial Diseases.Churg et.al. (eds.). New York: Igaku-Shoin, 1985 pp. 161, 168-171.
Tubular vacuolar change
Synopsis by: Harold Yamase M.D. (T71000M50070)[188]
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