# 上皮变性（Epithelium Degeneration）

- 器官 / 系统：附睾 / 雄性生殖系统（epididymis / reproductive-system-male）
- NTP 数据编号：ntp-0493
- 规范 URL：https://www.labsmart.cn/ntp/epididymis-epithelium-degeneration.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#epididymis-epithelium-degeneration
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/reproductive-system-male/epididymis/Epithelium-Degeneration
- 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
输出管或附睾上皮的变性（degeneration）和坏死（necrosis）是罕见的发现，无论是作为背景病变还是化学诱导的病变。

## 病变描述（中文）
输出管或附睾上皮的变性（degeneration）和坏死（necrosis）是罕见的发现，无论是作为背景病变还是化学诱导的病变。该病变的特征是附睾管上皮衬里的变薄和脱落。该发现不应与附睾腔内出现脱落的睾丸生殖细胞相混淆（另见附睾-管-脱落生殖细胞），在后一种情况下附睾上皮保持正常和完整。如果上皮衬里出现破损，通常伴有炎症细胞浸润，这是由于血-附睾屏障破坏导致免疫细胞暴露于具有抗原异性的精子所致。已有描述上皮变性见于暴露于甲基氯（methyl chloride）吸入后。

## 诊断与分级建议（NTP 共识，中文）
上皮变性应记录并分级，如果发生率和/或严重程度似乎与化学物给药相关，则应在病理学叙述中加以讨论。如果双侧附睾均受累，诊断应明确为双侧性，严重程度评分应基于受累更严重的附睾。与任何生精障碍的相关性应在病理学叙述中注明，以助于解释。细胞质空泡化（cytoplasmic vacuolation）虽属变性的一种形式，但应单独记录（另见附睾-上皮-空泡化）。相关链接：附睾-管-脱落生殖细胞 附睾-上皮-空泡化

## 英文原文 · Comment
Degeneration and necrosis of the efferent duct or epididymal epithelium are unusual findings, either as a background lesion or as a chemically induced lesion. The lesion is characterized by attenuation and sloughing of the epithelial lining of the epididymal duct. The finding should not be confused with the presence of sloughed testicular germ cells in the epididymal lumen (also see Epididymis - Duct - Exfoliated Germ Cell ), where the epididymal epithelium remains normal and intact. If there is a breach of the epithelial lining, it is generally accompanied by an inflammatory infiltrate due to breakdown in the blood-epididymal barrier resulting in exposure of immune cells to the antigenically foreign sperm. Epithelial degeneration has been described in response to methyl chloride inhalation.

## 英文原文 · Recommendation
Epithelial degeneration should be recorded and graded and should be discussed in the pathology narrative if the incidence and/or severity appears to be related to chemical administration. If both epididymides are involved, the diagnosis should be clarified as bilateral and the severity score based on the more severely affected epididymis. Correlation with any spermatogenic disturbances should be noted in the pathology narrative to aid interpretation. Cytoplasmic vacuolation, although a form of degeneration, should be recorded separately (also see Epididymis - Epithelium - Vacuolation ). Related Links: Epididymis - Duct - Exfoliated Germ Cell Epididymis - Epithelium - Vacuolation

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_0742.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_0738.jpg

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