Practical Application of Columbia Classification for Focal Segmental Glomerulosclerosis

被引:17
作者
Han, Man-Hoon [1 ]
Kim, Yong-Jin [2 ]
机构
[1] Kyungpook Natl Univ Hosp, Dept Pathol, 130 Dongdeok Ro, Daegu 41944, South Korea
[2] Yeungnam Univ, Coll Med, Dept Pathol, 170 Hyunchung Ro, Daegu 42415, South Korea
关键词
GLOMERULAR TIP LESION; JUXTAMEDULLARY; MUTATIONS; SCLEROSIS;
D O I
10.1155/2016/9375753
中图分类号
Q81 [生物工程学(生物技术)]; Q93 [微生物学];
学科分类号
071005 ; 0836 ; 090102 ; 100705 ;
摘要
Focal segmental glomerulosclerosis (FSGS) is a heterogeneous clinicopathological entity. Two frameworks for the classification of FSGS have been described: etiologic and morphologic. The etiologic classification is distinguished among genetic, adaptive, virus-associated, drug-induced, and idiopathic types. Morphologic classification is commonly referred to as the Columbia classification published in 2004, which distinguishes five variants: collapsing, tip, cellular, perihilar, and not otherwise specified (NOS). This classification is based on light microscopic patterns with rigorously defined specific criteria, which can be applied to primary and secondary forms of FSGS, and has been widely used over the past 10 years both as a diagnostic and as a prognostic clinical tool. This paper defines common histopathological features of FSGS, distinguished characters among five variants, and points out the confusion about terminology of variants, because most were proposed in the past with different definitions. Despite good interobserver reproducibility of this classification system, difficulty in its application may arise in the interpretation of lesions with mixed features of more than one variant in the same tissue specimen and with late lesions, because other variants may evolve into the NOS variant over time.
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页数:7
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