炎症Inflammation · 耳 · 特殊感觉系统 · NTP ntp-0357
诊断要点:耳部炎症应当诊断并分级。炎症类型(例如,急性或慢性活动性)应作为限定词在诊断中指明。
病变描述
耳部各区域的炎症可由多种原因引起,包括感染性病原体、异物、局部应用的刺激物和全身性毒物。耳部慢性炎症伴耳道内液体、耵聍和细胞碎片蓄积,可导致耳道囊性扩张(见耳-耳道-扩张)。在NTP研究中,炎症有五个标准类别:急性、化脓性、慢性、慢性活动性和肉芽肿性。在急性炎症中,主要浸润细胞是中性粒细胞,尽管也可能存在较少的巨噬细胞和淋巴细胞。也可能有水肿或充血的证据。中性粒细胞也是化脓性炎症中的主要浸润细胞类型,然而,在化脓性炎症中,中性粒细胞聚集,其中许多发生变性(化脓性渗出物)。渗出物中还可能存在细胞碎片(来自驻留细胞群和浸润的白细胞)、含纤维蛋白的蛋白性液体、较少的巨噬细胞、偶见的淋巴细胞或浆细胞,以及可能的感染性病原体。肉眼观,这些病变以脓液存在为特征。在渗出物周围组织中,可能存在成纤维细胞、纤维结缔组织和混合性炎症细胞,取决于病变的慢性程度。淋巴细胞在慢性炎症中占主导地位。淋巴细胞在慢性活动性炎症中也占主导地位,但在慢性活动性炎症中,还有显著数量的中性粒细胞。两种病变均可能含有巨噬细胞。肉芽肿性炎症是慢性炎症的另一种形式,但该诊断要求存在显著数量的聚集性、大型、活化巨噬细胞、上皮样巨噬细胞或多核巨细胞。
诊断与分级建议(NTP 共识)
耳部炎症应当诊断并分级。炎症类型(例如,急性或慢性活动性)应作为限定词在诊断中指明。同样,耳内病变的位置应使用适当的部位修饰词(外耳或中耳)指明。被认为继发性的所见(囊肿、上皮增生等)不应单独诊断,除非严重程度 warrant。未单独诊断的继发性病变应在病理学叙述中描述。相关链接:耳-耳道-扩张
图谱


英文原文
展开 NTP 官方英文描述与建议
Comment:
Inflammation of various ear regions can result from many causes, including infectious agents; foreign bodies; topically applied irritants, and systemic toxins. Chronic inflammation of the ear with accumulation of fluid, cerumen, and cellular debris in the ear canal can result in cystic dilation of the ear canal (see Ear - Canal - Dilation ). In NTP studies, there are five standard categories of inflammation: acute, suppurative, chronic, chronic-active, and granulomatous. In acute inflammation, the predominant infiltrating cell is the neutrophil, though fewer macrophages and lymphocytes may also be present. There may also be evidence of edema or hyperemia. The neutrophil is also the predominant infiltrating cell type in suppurative inflammation, however, in suppurative inflammation, the neutrophils are aggregated and many of them are degenerate (suppurative exudate). Cell debris, both from the resident cell populations and infiltrating leukocytes, proteinaceous fluid containing fibrin, fewer macrophages, occasional lymphocytes or plasma cells, and, possibly, an infectious agent may also be present in within the exudate. Grossly, these lesions would be characterized by the presence of pus. In the tissue surrounding the exudate, there may be fibroblasts, fibrous connective tissue, and mixed inflammatory cells, depending on the chronicity of the lesion. Lymphocytes predominate in chronic inflammation. Lymphocytes also predominate in chronic-active inflammation, but in chronic-active inflammation, there are also a significant number of neutrophils. Both lesions may contain macrophages. Granulomatous inflammation is another form of chronic inflammation, but this diagnosis requires the presence of a significant number of aggregated, large, activated macrophages, epithelioid macrophages, or multinucleated giant cells.
Recommendation:
Inflammation of the ear should be diagnosed and graded. The type of inflammation (e.g., acute or chronic active) should be indicated in the diagnosis as a qualifier. Similarly, the location of the lesion within the ear should be indicated with an appropriate site modifier (external ear or middle ear). Findings considered secondary (cyst, epithelial hyperplasia, etc.) should not be diagnosed separately unless warranted by severity. Secondary lesions not diagnosed separately should be described in the pathology narrative. Related Links: Ear - Canal - Dilation
来源与引用
原始条目:https://ntp.niehs.nih.gov/atlas/nnl/special-senses-system/ear/Inflammation
图谱总目录:NTP Nonneoplastic Lesion Atlas。 内容属美国联邦政府作品(公有领域),可引用;引用时请标注来源。
建议引用格式:NTP Nonneoplastic Lesion Atlas. Inflammation (ear). LabSmart 中文版:
https://www.labsmart.cn/ntp/ear-inflammation.html
中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#ear-inflammation