# 炎症（Inflammation）

- 器官 / 系统：附睾 / 雄性生殖系统（epididymis / reproductive-system-male）
- NTP 数据编号：ntp-0500
- 规范 URL：https://www.labsmart.cn/ntp/epididymis-inflammation.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#epididymis-inflammation
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/reproductive-system-male/epididymis/Inflammation
- 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
炎症通常发生于组织损伤和血-附睾屏障破坏时，导致炎症细胞局灶性广泛或弥漫性浸润导管腔、上皮和/或间质，并可能伴有水肿。

## 病变描述（中文）
炎症通常发生于组织损伤和血-附睾屏障破坏时，导致炎症细胞局灶性广泛或弥漫性浸润导管腔、上皮和/或间质，并可能伴有水肿。炎症可以是以中性粒细胞成分为主的急性炎症，也可以是以淋巴样聚集为特征的慢性炎症（Figure 1、Figure 2）。如果炎症反应包括围绕精子核心的肉芽肿性反应，则“精子肉芽肿”这一术语更为恰当（另见附睾-精子肉芽肿）。炎症是一种不常见的偶然性发现，但可能作为化学诱导的附睾变性（如甲基氯）的后遗症出现。NTP研究将炎症分为五个标准类别：急性、化脓性、慢性、慢性活动性和肉芽肿性。在急性炎症中，主要浸润细胞为中性粒细胞，但也可能存在较少的巨噬细胞和淋巴细胞。还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，但它们聚集在一起，其中许多已变性（化脓性渗出物）。渗出物中还可能存在来自驻留细胞群和浸润白细胞的细胞碎片、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，以及可能的感染因子。大体上，这些病变以脓液存在为特征。渗出物周围的组织可能有成纤维细胞、纤维结缔组织和混合性炎症细胞，取决于病变的慢性程度。慢性炎症中以淋巴细胞为主。慢性活动性炎症中也以淋巴细胞为主，但同时有大量中性粒细胞。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，但该诊断要求存在大量聚集的大型活化巨噬细胞、上皮样巨噬细胞或多核巨细胞。

## 诊断与分级建议（NTP 共识，中文）
“炎症”一词应保留用于有相关组织损伤证据的病例。炎症应记录并分级，如果发生率或严重程度似乎与化学物给药相关，应在病理学叙述中讨论。可使用修饰词来描述主要细胞类型。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。建议与其他雄性生殖器官的异常进行关联分析以辅助解释。相关链接：附睾-精子肉芽肿

## 英文原文 · Comment
Inflammation generally occurs in response to tissue injury and breakdown of the bloodepididymal barrier, resulting in focally extensive or diffuse infiltration of the ductular lumen, the epithelium, and/or the interstitium with inflammatory cells and possibly edema. The inflammation may be predominantly acute, with a significant neutrophil component, or chronic, with lymphoid aggregates ( Figure 1 and Figure 2 ). If the inflammatory response comprises a granulomatous reaction surrounding a core of sperm, the term "sperm granuloma" is more appropriate (also see Epididymis - Sperm Granuloma ). Inflammation is an uncommon incidental finding but may occur as a sequel to chemically induced epididymal degeneration (e.g., methyl chloride). NTP studies have 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 , but they are aggregated, and many of them are degenerate (suppurative exudate). Cell debris from both 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 the exudate. Grossly, these lesions would be characterized by the presence of pus. The tissue surrounding the exudate may have 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 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.

## 英文原文 · Recommendation
The term "inflammation" should be reserved for cases where there is associated evidence of tissue injury. Inflammation 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. A modifier may be used to characterize the predominant cell type. If both epididymides are affected, the diagnosis should be clarified as bilateral and the severity score based on the more severely affected epididymis. Correlation with disturbances in other male reproductive organs is recommended to aid interpretation. Related Links: Epididymis - Sperm Granuloma

## 配图
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