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<meta name="description" content="「検体数が少ない」「そもそもどこを見たらよいのかがわからない」「疾患が多彩で複雑」などの理由から，腎生検病理を苦手とする人は少なくない．そこで本書は，腎生検病理診断を行ううえで，まずは押さえておきたい病理所見の基本的な取り方を豊富な写真と明瞭な解説で紐解き，「臨床情報からの鑑別」について詳解することで，病理・臨床双方の所見から総合的に病態を理解できるように誌面を構成した．各論では，各執筆者が主な疾">

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		<h1 class="catchCopy">800点以上の写真で，腎生検病理診断の基本となる所見の取り方と鑑別診断が身につく！</h1>
		

		<h1 class="copy">非腫瘍性疾患病理アトラス</h1>
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					編集：大橋健一（東京医科歯科大学教授）
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					<span class="transparent">編集</span>　小池淳樹（聖マリアンナ医科大学教授）
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="preface">序文</h3><h3 class="indexes">主要目次</h3></div><section class="current content">「検体数が少ない」「そもそもどこを見たらよいのかがわからない」「疾患が多彩で複雑」などの理由から，腎生検病理を苦手とする人は少なくない．そこで本書は，腎生検病理診断を行ううえで，まずは押さえておきたい病理所見の基本的な取り方を豊富な写真と明瞭な解説で紐解き，「臨床情報からの鑑別」について詳解することで，病理・臨床双方の所見から総合的に病態を理解できるように誌面を構成した．各論では，各執筆者が主な疾患と鑑別診断の「見るべきポイント」を丁寧に解説．腎病理を専門としない病理医や腎臓内科医必携の1冊！<br><br>＊『病理と臨床』41巻4号では，本書の刊行記念座談会の記事が掲載されております．下記のリンクにて誌面をご覧いただけます．<br><a href="https://www.bunkodo.co.jp/browse/0V2ZP9SCF43KYWCO5LZX/index.html" class="bunkodo_link">『病理と臨床』41巻4号「非腫瘍性疾患病理アトラス 腎」刊行記念座談会はこちら<i class="material-icons">open_in_new</i></a><br><a href="https://www.bunkodo.co.jp/magazine/82HPS4L8MK.html" class="bunkodo_link">『病理と臨床』41巻4号はこちら<i class="material-icons">open_in_new</i></a></section><section class="preface">序<br><br>　腎臓内科診療の盛んな病院では様々な疾患に対し，腎生検が行われ，確定診断，病勢の把握，治療法の選択，腎予後の予測などに役立てています．しかし，診断を担当する一般病理医にとって腎生検診断を苦手とする声はしばしば聞かれます．一般病理医が腎生検診断を苦手とする理由は様々と思われます．疾患が多彩であり，概念，診断基準を理解するのが大変である点，光学顕微鏡診断においてHE染色以外にPAS，PAM，Masson trichrome染色など多数の染色切片の観察が必要であり，加えて蛍光抗体法，電子顕微鏡所見も参照しなくてはならない点，各病院における腎生検数が必ずしも多くなく，経験できる症例数が限られる点，身近に腎病理の専門医がおらず，指導，コンサルテーションが受けにくい点，腎病理に詳しい腎臓内科医が診断の多くを担当し，蛍光抗体法，電子顕微鏡による結果が参照できず，病理医の診断が必ずしも信用されていない点などが考えられます．腎病理診断も本来は病理医が診断を担当し，臨床医とのカンファレンスを通して診断を深めていく必要があると考えますが，そのためには病理医に腎病理の基礎知識，経験が必要になります．<br>　これまで腎生検診断を勉強する腎臓内科医，病理医を対象とした腎生検診断入門書，腎生検病理アトラスは多数出版されてきました．その多くが各疾患の概念，病理組織像，蛍光抗体法所見，電子顕微鏡所見，鑑別診断を解説したものが主体となっていますが，初学者にとっては所見をどのように取ったらよいか，それぞれの所見からどのような疾患を想起すべきかがわからないとの意見がよく聞かれます．本書は総論と各論から構成されていますが，前半の総論に比較的多くのページを割いており，様々な腎病理の基本的所見の内容，それぞれからどのような疾患を想起し，鑑別診断を進めるべきかについて解説しています．また，診断のプロセス，臨床情報からの鑑別診断についてもまとめています．後半の各論においては，あまり稀な疾患にまで対象を広げず，一般病院においてもしばしば経験される疾患，主に 最近のトピックスについて解説しています．前半の総論と後半の各論では扱う疾患，所見，写真などが重複する場合がありますが，辞書のように本書を利用することによって，総論，各論のどこをみても正しい鑑別診断に至るように配慮しています．今回編集は4 名で行いましたが，項目ごとの用語等の矛盾，不適切な表現などがなくなるようにできるだけチェックを行いました．<br>　本書が日常病理診断業務を行う病理医，腎病理を学ぶ研修医，腎臓内科医，学生にとっても役立ち，腎病理診断に対する苦手意識が少しでもなくなり，腎病理の魅力を理解していただけることを切に願います．<br><br>2022年10月<br>大橋健一，小池淳樹，冨田茂樹，原　重雄</section><section class="indexes">第1部　総　論<br>A．正常腎の組織所見<br>　Ⅰ　腎の発生 <br>　Ⅱ　糸球体の構造<br>　Ⅲ　尿細管と間質<br>　Ⅳ　血　管 <br>B．腎病理組織学の基本的所見　<br>　Ⅰ　糸球体の所見 <br>　　1　メサンギウム増殖 <br>　　2　管内細胞増多 <br>　　3　膜性増殖性病変 <br>　　4　半月体形成─管外増殖─ <br>　　5　内皮障害，係蹄基底膜の二重化 <br>　　6　spike形成<br>　　7　足細胞（ポドサイト）の病変 <br>　　8　糸球体結節性病変 <br>　　9　糸球体硬化 <br>　　10　分節性硬化 <br>　Ⅱ　尿細管・間質の所見 <br>　　1　間質炎症 <br>　　2　間質線維化<br>　　3　尿細管萎縮 <br>　Ⅲ　血管の所見 <br>　　1　動脈硬化 <br>　　2　細動脈硝子化<br>　　3　血管炎 <br>C．腎生検診断のプロセス<br>　Ⅰ　腎生検検体の取扱い <br>　Ⅱ　特殊染色で観察するポイント <br>　Ⅲ　腎生検診断・観察の進め方 <br>D．臨床情報からの鑑別診断<br>　Ⅰ　ネフローゼ症候群<br>　Ⅱ　蛋白尿・血尿の持続<br>　Ⅲ　急性腎障害（AKI）<br>　Ⅳ　M蛋白血症 <br>　Ⅴ　時系列でみた移植腎病理の考え方 <br>　Ⅵ　家族歴を有する腎疾患<br><br>第2部　各　論<br>　主な疾患と鑑別診断<br>　　1　微小変化型ネフローゼ症候群と巣状分節性糸球体硬化症<br>　　2　IgA腎症とIgA血管炎<br>　　3　膜性腎症<br>　　4　C3腎症と膜性増殖性糸球体腎炎パターンを呈する糸球体腎炎<br>　　〔COLUMN〕膜性増殖性糸球体腎炎の分類Up To Date<br>　　5　単クローン性IgG沈着を伴う増殖性腎炎<br>　　6　糖尿病性腎症 <br>　　7　アミロイドーシス <br>　　〔COLUMN〕質量分析を用いたアミロイドの病型診断<br>　　8　organized depositsを伴う腎疾患<br>　　9　ループス腎炎・膠原病関連腎症─血管炎を除く─<br>　　10　感染関連腎炎 <br>　　11　遺伝性腎疾患 <br>　　12　糸球体過剰濾過に関連した腎疾患<br>　　13　ANCA関連血管炎，抗GBM病<br>　　14　血栓性微小血管症（TMA） <br>　　〔COLUMN〕Castleman病，TAFRO症候群，POEMS症候群<br>　　15　腎硬化症 <br>　　16　尿細管間質性腎炎，急性尿細管壊死<br>　　17　IgG4関連腎臓病 <br>　　〔COLUMN〕IgM陽性形質細胞浸潤を伴った尿細管間質性腎炎（IgMPC-TIN） <br>　　18　造血幹細胞移植に関連した腎障害<br>　　19　薬剤性腎障害 <br>　　〔COLUMN〕免疫チェックポイント阻害薬による腎障害<br>　　〔COLUMN〕クロロキン関連腎症<br>　　20　悪性リンパ腫の浸潤─血管内大細胞型B細胞リンパ腫を含む─ <br>　　21　移植腎─拒絶─ <br>　　22　移植腎─ウイルス感染─<br><br>索　引</section></article>
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