# 骨髓凝胶样转化（Gelatinous Transformation）

- 器官 / 系统：骨髓 / 造血系统（bone-marrow / hematopoietic-system）
- NTP 数据编号：ntp-0437
- 规范 URL：https://www.labsmart.cn/ntp/bone-marrow-gelatinous-transformation.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#bone-marrow-gelatinous-transformation
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/hematopoietic-system/bone-marrow/GelatinousTransformation
- 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
骨髓胶样转化（gelatinous transformation of bone marrow，GMT），以前称为“脂肪浆液性萎缩（serous atrophy of fat）”，是一种不常见的病变，表现为脂肪细胞（脂肪萎缩）和造血细胞丢失，代之以细胞外基质（ground substance）增多（

## 病变描述（中文）
骨髓胶样转化（gelatinous transformation of bone marrow，GMT），以前称为“脂肪浆液性萎缩（serous atrophy of fat）”，是一种不常见的病变，表现为脂肪细胞（脂肪萎缩）和造血细胞丢失，代之以细胞外基质（ground substance）增多（Figure 1、Figure 2、Figure 3）。该病变最常呈局灶性（focal）或多灶性（multifocal）分布。基质为无定形、淡粉色，有时外观略呈颗粒状，通常由酸性黏多糖组成，在pH 2.5时Alcian blue染色呈阳性（人类、马）。为确保Alcian blue染色阳性，需要特定的组织制备和处理。GMT曾在衰弱啮齿类动物中有描述，通常与恶病质（如继发于肿瘤、内分泌病）和晚期严重营养不良（如消化不良）相关。然而，在当前的饲养标准下，GMT在如今的NTP研究中很少遇到。尽管GMT的发病机制仍不清楚，但其与多种疾病的关联提示，它可能源于晚期疾病状态下被激活的基本生物调节过程。有观点认为，基质可能是对疾病分解代谢状态下被消耗的脂肪细胞的替代，而造血细胞丢失可能是由于骨髓微环境不利所致，这与造血底物不足以及缺乏脂肪细胞和纤维细胞的刺激有关。

## 诊断与分级建议（NTP 共识，中文）
骨髓胶样转化应始终记录并分级。严重程度分级基于骨髓受累的范围。较旧的术语“浆液性变性（serous degeneration）”、“骨髓变性（bone marrow degeneration）”、“脂肪浆液性萎缩（serous atrophy of fat）”和“脂肪变性（fat degeneration）”不应被用于诊断该病变。

## 英文原文 · Comment
Gelatinous transformation of bone marrow (GMT), previously known as "serous atrophy of fat," is an uncommon condition in which there is a loss of adipocytes (fat atrophy) and hematopoietic cells, with replacement by an increased amount of extracellular ground substance ( Figure 1 , Figure 2 , and Figure 3 ). This lesion is most often focal or multifocal. The ground substance is amorphous, light pink, and sometimes slightly granular in appearance and typically consists of acid mucopolysaccharides that stain positive with Alcian blue at pH 2.5 (humans, equids). To ensure Alcian blue positivity, specific tissue preparation and processing are necessary. GMT has been described in debilitated rodents and in general is associated with cachexia (e.g., secondary to neoplasia, endocrinopathies) and advanced severe malnutrition (e.g., maldigestion). Under current husbandry standards, however, GMT is rarely encountered in NTP studies today. Although the pathogenesis of GMT remains unclear, its association with a wide range of diseases suggests it may result from basic bioregulatory processes that are activated in states of advanced illness. It has been suggested that the ground substance may be a replacement for the adipocytes that are used in catabolic states of disease, while the hematopoietic cell loss may be due to an unfavorable bone marrow microenvironment related to inadequate hematopoietic substrates and lack of stimulation by adipocytes and fibrocytes.

## 英文原文 · Recommendation
Gelatinous transformation of bone marrow should always be recorded and graded. Severity grade is based on the extent of marrow affected. The older terms "serous degeneration," "bone marrow degeneration," "serous atrophy of fat," and "fat degeneration" should not be used to diagnose this finding.

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_0317.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_0315.jpg

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