# 结晶（Crystals）

- 器官 / 系统：肾脏 / 泌尿系统（kidney / urinary-system）
- NTP 数据编号：ntp-0161
- 规范 URL：https://www.labsmart.cn/ntp/kidney-crystals.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#kidney-crystals
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/urinary-system/kidney/Crystals
- 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
结晶可出现在肾小管的任何节段或肾盂（Figure 1、Figure 2）。在常规光学显微镜下，结晶往往难以发现，因为它们在组织处理过程中常被洗脱，或在光学上不明显。

## 病变描述（中文）
结晶可出现在肾小管的任何节段或肾盂（Figure 1、Figure 2）。在常规光学显微镜下，结晶往往难以发现，因为它们在组织处理过程中常被洗脱，或在光学上不明显。结晶的存在用偏振光可能更好地显示，因为它们常具有双折射性。另一方面，矿化不具有双折射性。由化学物质和/或代谢产物给药所致的结晶，可因尿滤液的浓度和pH值而在肾单位的任何节段沉淀。此外，某些化学物质在肾脏存在特定条件时是不溶的。许多结晶具有高度刺激性，取决于其大小和形状，并可能导致肾小管变性和/或坏死，以及随后的急性至慢性炎症或肾盂肾炎（见肾脏 - 肾病，梗阻性）。偶尔，结晶可在巨噬细胞或多核巨细胞内被识别（Figure 3）。

## 诊断与分级建议（NTP 共识，中文）
结晶只要存在就应诊断并给出严重程度分级。结晶的位置应作为部位修饰词纳入诊断（例如，肾小管或肾盂）。结晶的特征应在病理学描述中讨论。继发性病变，如炎症，除非严重程度足以需要，否则不应单独诊断，但应在病理学描述中描述。相关链接：肾脏 - 结石 肾脏 - 矿化 肾脏 - 肾病，梗阻性

## 英文原文 · Comment
Crystals can occur in any of the renal tubule segments or renal pelvis ( Figure 1 and Figure 2 ). Crystals are often difficult to find with routine light microscopy because they are often washed out in tissue processing or are optically inapparent. The presence of crystals may be better visualized with polarized light as they are often birefringent. Mineralization, on the other hand, is not birefringent. Crystals resulting from the administration of chemical and/or metabolites may precipitate in any segment of the nephron because of the concentration and pH of the urine filtrate. In addition, a number of chemicals are insoluble when certain conditions are present in the kidney. Many crystals are highly irritating, depending on their size and shape, and may result in tubule degeneration and/or necrosis and subsequent acute to chronic inflammation or pyelonephritis (see Kidney - Nephropathy, Obstructive ). Occasionally, crystals may be identified within macrophages or multinucleated giant cells ( Figure 3 ).

## 英文原文 · Recommendation
Crystals should be diagnosed and given a severity grade whenever present. The location of the crystals should be included in the diagnosis as a site modifier (e.g., renal tubule or pelvis). The features of the crystals should be discussed in the pathology narrative. Secondary lesions, such as inflammation, should not be diagnosed separately unless warranted by severity, but should be described in the pathology narrative. Related Links: Kidney - Calculus Kidney - Mineralization Kidney - Nephropathy, Obstructive

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_1063.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_1060.jpg

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