炎症Inflammation · 哈氏腺 · 特殊感觉系统 · NTP ntp-0318

依据美国国家毒理学计划(NTP)Nonneoplastic Lesion Atlas 整理 · 中文译文与诊断建议 · 仅供科研使用,不用于临床诊断

一句话结论:哈德氏腺(Harderian gland)炎症可继发于球后采血操作造成的创伤,也可由其他原因引起,如感染性病原体(例如涎泪腺炎病毒,sialodacryoadenitis virus)、异物、过度光照以及某些营养缺乏。
诊断要点:哈德氏腺炎症应当诊断并赋予严重程度分级。诊断中应当包括适当的类型修饰词(急性、慢性等)。

病变描述

哈德氏腺(Harderian gland)炎症可继发于球后采血操作造成的创伤,也可由其他原因引起,如感染性病原体(例如涎泪腺炎病毒,sialodacryoadenitis virus)、异物、过度光照以及某些营养缺乏。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(慢性活动性(chronic-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,然而,在化脓性炎症中,中性粒细胞聚集,其中许多发生退变(化脓性渗出物,化脓性 exudate)。渗出物中还可能存在细胞碎片(来自 resident 细胞群和浸润白细胞)、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。大体上,这些病变以脓液存在为特征。在渗出物周围的组织中,可能存在成纤维细胞、纤维结缔组织和混合性炎症细胞,具体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,还存在大量中性粒细胞。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、大的、活化的巨噬细胞、上皮样巨噬细胞(epithelioid macrophages)或多核巨细胞。炎症与细胞浸润的不同之处在于,炎症病变有组织损伤的证据,如水肿、出血、变性、坏死、再生等。

诊断与分级建议(NTP 共识)

哈德氏腺炎症应当诊断并赋予严重程度分级。诊断中应当包括适当的类型修饰词(急性、慢性等)。哈德氏腺中的异物可以单独诊断为存在(不赋予严重程度分级)。相关病变(例如坏死)不应单独诊断(除非严重程度 warrant),但可在叙述中描述。相关链接:哈德氏腺 - 细胞浸润,单核细胞(Harderian Gland - Infiltration Cellular, Mononuclear Cell)

图谱

炎症(哈氏腺)组织学图谱 1
图 1 · 炎症 · 来源:NTP NNL Atlas
炎症(哈氏腺)组织学图谱 2
图 2 · 炎症 · 来源:NTP NNL Atlas

英文原文

展开 NTP 官方英文描述与建议

Comment:
Harderian gland inflammation can be secondary to trauma from retrobulbar bleeding procedures and can be result from other causes, such as infectious agents (e.g., sialodacryoadenitis virus), foreign bodies, excessive exposure to light, and certain nutritional deficiencies. 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. Inflammation differs from cellular infiltration in that inflammatory lesions have evidence of tissue damage, such as edema, hemorrhage, degeneration, necrosis, regeneration, etc.

Recommendation:
Harderian gland inflammation should be diagnosed and assigned a severity grade. An appropriate type modifiers (acute, chronic, etc.) should be included in the diangosis. Foreign bodies in the Harderian gland can be diagnosed separately as present (without assignment of a severity grade). Associated lesions (e.g., necrosis) should not be diagnosed separately (unless warranted by severity), though they can be described in the narrative. Related Links: Harderian Gland - Infiltration Cellular, Mononuclear Cell

来源与引用

原始条目:https://ntp.niehs.nih.gov/atlas/nnl/special-senses-system/harderian-gland/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 (harderian-gland). LabSmart 中文版: https://www.labsmart.cn/ntp/harderian-gland-inflammation.html

中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#harderian-gland-inflammation

出血单核细胞性细胞浸润囊肿坏死增生扩张