Glomerular tuft ballooning in mitomycin-C-induced renal impairment

Severe ballooning of the glomerular tufts was observed in a 65-year-old man who was treated with mitomycin C (MMC) and had typical MMC-induced renal lesions. He developed renal failure and severe anaemia 6 months after initiation of chemotherapy. Ballooned tufts were caused by enormous expansion of the sub-endothelial space simultaneously associated with mesangiolysis. Glomerular cysts, described in a variety of disorders including thrombotic microangiopathy and diabetes mellitus, are derived from cystically dilated and united capillary luminae secondary to mesangiolysis. The morphogenesis of this unusual lesion when induced by MMC differs from that of the glomerular cysts previously reported.