# 出血（Hemorrhage）

- 器官 / 系统：肾上腺 / 内分泌系统（adrenal-gland / endocrine-system）
- NTP 数据编号：ntp-0069
- 规范 URL：https://www.labsmart.cn/ntp/adrenal-gland-hemorrhage.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#adrenal-gland-hemorrhage
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/endocrine-system/adrenal-gland/Hemorrhage
- 授权：美国联邦政府作品，公有领域；引用请标注 NTP Nonneoplastic Lesion Atlas
- 适用说明：仅供科研使用，不用于临床诊断

## 一句话结论
肾上腺出血（Adrenal gland hemorrhage，Figure 1、Figure 2、Figure 3、Figure 4）的特征是皮质和/或髓质内出现数量不等的外渗血细胞。

## 病变描述（中文）
肾上腺出血（Adrenal gland hemorrhage，Figure 1、Figure 2、Figure 3、Figure 4）的特征是皮质和/或髓质内出现数量不等的外渗血细胞。出血可为局灶性（focal）或弥漫性（diffuse），严重程度从小的局灶性区域到广泛受累不等，广泛受累可扭曲甚至破坏正常结构（Figure 1、Figure 2、Figure 3、Figure 4）。肾上腺出血可继发于许多自发性或治疗相关的病理过程，如原发性血管疾病、全身性凝血病、梗死和败血症。已知许多化学物质以及极高剂量的外源性促肾上腺皮质激素（adrenocorticotropic hormone，ACTH）可引起肾上腺出血（主要发生在皮质），且常与坏死相关。

## 诊断与分级建议（NTP 共识，中文）
肾上腺出血应予以诊断，并赋予严重程度分级、部位修饰词（即皮质、髓质）和分布修饰词（即局灶性（focal）、弥漫性（diffuse））。如果皮质和髓质均存在出血，可省略部位修饰词，并在病理学描述中说明位置。继发于其他病变（如囊性变性、炎症或坏死）的出血不应单独诊断，除非严重程度足以支持单独诊断，但可在病理学描述中加以描述。

## 英文原文 · Comment
Adrenal gland hemorrhage ( Figure 1 , Figure 2 , Figure 3 , and Figure 4 ) is characterized by the presence of variable amounts of extravasated blood cells in the cortex and/or medulla. Hemorrhage can be focal or diffuse and range in severity from a small focal area to extensive involvement that can distort or even obliterate normal architecture ( Figure 1 , Figure 2 , Figure 3 , and Figure 4 ). Adrenal hemorrhage can be secondary to many spontaneous or treatment-related pathologic processes such as primary vascular disease, systemic coagulopathy, infarction, and septicemia. Many chemicals, as well as very high doses of exogenous adrenocorticotropic hormone (ACTH), are known to cause adrenal hemorrhage (primarily in the cortex), often in association with necrosis.

## 英文原文 · Recommendation
Adrenal hemorrhage should be diagnosed and assigned a severity grade, site modifier (i.e., cortex, medulla), and distribution modifier (i.e., focal, diffuse). If it is present in both the cortex and medulla, the site modifier may be omitted and the location described in the pathology narrative. Hemorrhage secondary to other lesions (e.g., cystic degeneration, inflammation, or necrosis) should not be diagnosed separately, unless warranted by severity, but may be described in the pathology narrative.

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_0241.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_0237.jpg

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