# 色素（Pigment）

- 器官 / 系统：骨髓 / 造血系统（bone-marrow / hematopoietic-system）
- NTP 数据编号：ntp-0435
- 规范 URL：https://www.labsmart.cn/ntp/bone-marrow-pigment.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#bone-marrow-pigment
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/hematopoietic-system/bone-marrow/Pigment
- 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
铁以含铁血黄素（hemosiderin）的形式储存于骨髓的驻留巨噬细胞中。骨髓内含铁血黄素量的增加记录为色素（增加）。

## 病变描述（中文）
铁以含铁血黄素（hemosiderin）的形式储存于骨髓的驻留巨噬细胞中。骨髓内含铁血黄素量的增加记录为色素（增加）。含铁血黄素在苏木精和伊红（H&E）染色下呈金黄色至棕褐色色素，在Wright染色下呈绿色、蓝绿色或黑色。尽管巨噬细胞中见到的金黄色至棕褐色色素最可能代表含铁血黄素，但需要特殊染色（如Prussian blue）加以确认。由于铁通常储存于骨髓中，因此需与同部位同期对照比较来评估和分级色素沉着的程度。骨髓含铁血黄素增加与陈旧性或慢性出血或溶血性贫血相关，或由经口或胃肠外给予过量铁（铁过载）所致。炎症性（或慢性）疾病所致贫血也可导致骨髓含铁血黄素增加。这是由于肝脏产生hepcidin增加所致，hepcidin是炎症性贫血的关键介质。Hepcidin通过抑制肠道上皮对膳食铁的吸收和阻止铁从巨噬细胞输出，在维持正常铁稳态中发挥作用。炎症性和肿瘤性疾病引起hepcidin产生增加，随时间推移导致骨髓内铁储存增加。这些铁储存无法用于红细胞生成，进而促进贫血的发生。

## 诊断与分级建议（NTP 共识，中文）
虽然骨髓内的金黄色至棕褐色色素被推定为含铁血黄素，但未经特殊染色无法确认。因此，“色素”被认为是最合适的诊断。亚慢性和慢性研究中的色素增加应始终记录，其分级基于与同部位同期对照相比所存在色素的相对量。当色素增加与受试物相关时，应在叙述中描述为与含铁血黄素一致。

## 英文原文 · Comment
Iron is stored as hemosiderin in resident macrophages of the bone marrow. An increase in the amount of hemosiderin within the bone marrow is recorded as (increased) pigment. Hemosiderin appears as a golden brown pigment with hematoxylin and eosin stain and as green, blue-green, or black with Wright’s stain. Although golden brown pigment seen in macrophages most likely represents hemosiderin, a special stain, such as Prussian blue, would be needed for confirmation. Since iron is normally stored in the marrow, the level of pigmentation is assessed and graded in comparison with same-site concurrent controls. Increased hemosiderin of the bone marrow is associated with old or chronic hemorrhage or hemolytic anemia or is due to the administration of excessive amounts of oral or parenteral iron (iron overload). Anemia of inflammatory (or chronic) disease may also result in increased bone marrow hemosiderin. This is due to increased production of hepcidin, a key mediator of anemia of inflammation, by the liver. Hepcidin plays a role in maintaining normal iron homeostasis by inhibiting absorption of dietary iron from the intestinal epithelium and preventing the export of iron from macrophages. Inflammatory and neoplastic disorders cause an increase in hepcidin production that with time results in increased iron stores within the bone marrow. These iron stores are unavailable for erythropoiesis, subsequently contributing to the development of anemia.

## 英文原文 · Recommendation
While golden brown pigment within the bone marrow is presumed to be hemosiderin, it cannot be confirmed without special stains. Thus, “pigment” is deemed the most appropriate diagnosis. Increases in pigment in subchronic and chronic studies should always be documented, with grading based on the relative amounts of pigment present in comparison with same-site concurrent controls. When an increase in pigment is treatment related, it should be described in the narrative as being consistent with hemosiderin.

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_0324.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_0329.jpg

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