1. Nat. Rev. Nephrol. doi:10.1038/nrneph.2016.101
Figure 2 Sites of interstitial plaque in idiopathic calcium oxalate (CaOx) stone formers
Figure 2 | Sites of interstitial plaque in idiopathic calcium oxalate (CaOx) stone formers. a | Endoscopic image showing irregular whitish regions of interstitial plaque covering the papillary tip. b | A biopsy sample from this region showing black Yasue-stained calcium phosphate interstitial plaque (arrow) within the inner medulla and papillum. c | Light microscopy and d | transmission electron microscopy images showing regions of plaque (arrows) in the basement membrane of the thin loops of Henle only, suggesting that plaque originates at this site. e | The plaque is composed of laminated spheres with up to nine alternating light (hydroxyapatite) and dark (matrix) layers. f | Micro CT image of plaque that has filled the interstitium. Open spaces are the tubules and vascular structures around which plaque has deposited with no evidence of intraluminal deposits. g | Transmission electron microscopy image showing a multilayered ribbon-like structure separating a region of interstitial plaque (lower right) from an overgrowth of developing stone (upper left). In the thickest region of the white lamina of the ribbon (insert), tiny thin spicules run perpendicular to the surface adjacent to voids containing tightly packed crystals (thin arrows). Numerous small crystals have grown into the outer border of the ribbon (asterisk) and merged with large crystals within the urinary space at the developing overgrowth. The large double arrows indicate a large in-growing crystal.
Coe, F. L. et al. (2016) Idiopathic hypercalciuria and formation of calcium renal stones
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