# 精子肉芽肿（Sperm Granuloma）

- 器官 / 系统：附睾 / 雄性生殖系统（epididymis / reproductive-system-male）
- NTP 数据编号：ntp-0503
- 规范 URL：https://www.labsmart.cn/ntp/epididymis-sperm-granuloma.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#epididymis-sperm-granuloma
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/reproductive-system-male/epididymis/SpermGranuloma
- 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
当精子通过上皮衬里的破裂进入间质，或炎症细胞进入小管腔内与精子接触时，就会发生精子肉芽肿（sperm granuloma）。

## 病变描述（中文）
当精子通过上皮衬里的破裂进入间质，或炎症细胞进入小管腔内与精子接触时，就会发生精子肉芽肿（sperm granuloma）。如果向间质破裂，附睾衬里可能自行修复并通过附睾管维持精子的连续性。精子肉芽肿最常见于附睾尾，但可发生于整个附睾以及输出管。如果发生于输出管并阻碍精子和液体从睾丸流出，由于上游积聚的反压，将导致相关睾丸继发性小管扩张和/或萎缩。该病变的特征是中央积聚的精子，周围环绕肉芽肿性异物炎症反应，通常含有大量多核巨细胞（箭头，Figure 1、Figure 2）（另见附睾 - 炎症）。精子肉芽肿可作为任何年龄啮齿动物的偶然背景性发现，但也可能由化学物质诱导。

## 诊断与分级建议（NTP 共识，中文）
精子肉芽肿应当被诊断并分级，如果其发生率和/或严重程度似乎与化学物给药相关，则应当在病理学叙述中讨论。存在双侧受累时应记录，适当时可使用修饰词记录其在附睾内的位置。附睾中的相关病变不应单独诊断，除非严重程度确有必要。睾丸中的相关病变可单独诊断，并在叙述中注明其与精子肉芽肿的关联。相关链接：附睾 - 炎症

## 英文原文 · Comment
Sperm granulomas occur when sperm is released into the interstitium through a rupture in the epithelial lining or when inflammatory cells gain access to the sperm within the ductular lumen. If there is rupture into the interstitium, the epididymal lining may repair itself and maintain sperm continuity through the epididymal duct. Sperm granulomas are most commonly seen in the cauda epididymis but can occur throughout the epididymis, as well as the efferent ducts. If they occur in the efferent ducts and obstruct the outflow of sperm and fluid from the testis, they will result in secondary tubular dilation and/or atrophy in the associated testis due to the accumulated backpressure upstream. The lesion is characterized by a central accumulation of sperm surrounded by a granulomatous foreign body inflammatory response, which generally contains numerous multinucleated giant cells (arrows, Figure 1 and Figure 2 ) (Also see Epididymis - Inflammation ). Sperm granulomas occur as an incidental background finding in any age of rodent but can also be chemically induced.

## 英文原文 · Recommendation
Sperm granulomas should be diagnosed and graded and should be discussed in the pathology narrative if the incidence and/or severity appears to be related to chemical administration. Bilateral involvement should be recorded when present, and a modifier can be used to record location within the epididymis if appropriate. Associated lesions in the epididymides should not be diagnosed separately unless warranted by severity. Associated lesions in the testes may be diagnosed separately and their association to the sperm granuloma noted in the narrative. Related Links: Epididymis - Inflammation

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_0747.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_0751.jpg

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