炎症Inflammation · 食管 · 消化系统 · NTP ntp-0308
诊断要点：无论何时出现，炎症均应予以诊断并分级。诊断应包括指明炎症持续时间或类型的修饰词（即 急性（acute）、化脓性（suppurative）、慢性（chronic）、慢性 active 或 肉芽肿性（granulomatous））。
病变描述
在 NTP 研究中，化学物质对食管的直接毒性作用罕见。啮齿类动物的食管炎症最常由灌胃创伤引起，并可伴有溃疡、坏死和穿孔。在 NTP 研究中，炎症有五个标准类别：急性（急性（acute））、化脓性（化脓性（suppurative））、慢性（慢性（chronic））、慢性活动性（慢性 active）和肉芽肿性（肉芽肿性（granulomatous））。在急性炎症中，主要浸润细胞是中性粒细胞（neutrophil），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表现。中性粒细胞也是化脓性炎症中的主要浸润细胞类型，但中性粒细胞聚集，且其中许多发生变性（化脓性渗出物）。渗出物还可能含有细胞碎片，既来自 resident 细胞群体，也来自浸润的白细胞；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；以及可能的感染因子。肉眼观察，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，但也存在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。因灌胃创伤继发细菌感染的化脓性炎症在食管中相对常见（Figure 1、Figure 2、Figure 3、Figure 4）。
诊断与分级建议（NTP 共识）
无论何时出现，炎症均应予以诊断并分级。诊断应包括指明炎症持续时间或类型的修饰词（即 急性（acute）、化脓性（suppurative）、慢性（chronic）、慢性 active 或 肉芽肿性（granulomatous））。严重程度分级取决于食管中病变的范围和细胞浸润的密度。符合脓肿的病变诊断为化脓性炎症。相关坏死或炎症通常不予记录，除非炎症或坏死是病变的重要组成部分。
图谱
英文原文
展开 NTP 官方英文描述与建议
Comment：
Direct toxic effects of chemicals on the esophagus are rare in NTP studies. Esophageal inflammation in rodents is most commonly caused by gavage trauma and can be associated with ulceration, necrosis, and perforation. 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 , but the neutrophils are aggregated, and many of them are degenerate (suppurative exudate). The exudate may also contain cell debris, both from the resident cell populations and from infiltrating leukocytes; proteinaceous fluid containing fibrin; fewer macrophages; occasional lymphocytes or plasma cells; and, possibly, an infectious agent. 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 a significant number of neutrophils are also present. 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. Suppurative inflammation with secondary bacterial infection due to gavage trauma is relatively common in the esophagus ( Figure 1 , Figure 2 , Figure 3 , and Figure 4 ).
Recommendation：
Whenever present, inflammation should be diagnosed and graded. The diagnosis should include a modifier indicating the duration or type of inflammation (i.e., acute, suppurative, chronic, chronic active, or granulomatous). The severity grade depends on the extent of the lesion in the esophagus and the density of the cellular infiltrate. Lesions consistent with an abscess are diagnosed as suppurative inflammation. Associated necrosis or inflammation is not generally recorded unless the inflammation or necrosis is a significant component of the lesion.
来源与引用
原始条目：https://ntp.niehs.nih.gov/atlas/nnl/alimentary-system/esophagus/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 (esophagus). LabSmart 中文版：
https://www.labsmart.cn/ntp/esophagus-inflammation.html
中文图谱总页（可展开对照全部 595 条）：https://www.labsmart.cn/ntp-atlas.html#esophagus-inflammation