纤维化Fibrosis · 肾脏 · 泌尿系统 · NTP ntp-0160
诊断要点:如果纤维化是原发性改变,或伴有轻微炎症或无炎症,则应作出诊断并给出严重程度分级。
病变描述
肾(间质)纤维化与肾实质既往或持续存在的损伤有关,例如与慢性间质性炎症相关的损伤。纤维化的程度取决于诱发因素、肾实质损伤的程度以及病变的慢性程度。纤维化源于复杂的相互作用,涉及炎症细胞释放的细胞因子、肾小管上皮-间质转化尚有争议的影响,以及由于胶原溶解酶受抑制而导致的胶原清除减少。纤维化在间质中表现为略呈纤维状的嗜酸性物质(Figure 1、Figure 2)。纤维化可导致受累区域肾单位进行性萎缩和/或肾小管及鲍曼氏囊扩张。
诊断与分级建议(NTP 共识)
如果纤维化是原发性改变,或伴有轻微炎症或无炎症,则应作出诊断并给出严重程度分级。当纤维化继发于另一过程(如炎症),且两者同时存在时,病理学家应运用其判断来决定纤维化是否足够显著而需要单独诊断。相关链接:肾脏 - 梗死 肾脏 - 炎症
图谱


英文原文
展开 NTP 官方英文描述与建议
Comment:
Renal (interstitial) fibrosis is associated with previous or ongoing injury to the renal parenchyma,such as that associated with chronic interstitial inflammation. The amount of fibrosis dependson the inciting condition, the amount of damage to the renal parenchyma, and the chronicity of the lesion. Fibrosis results from a complex interaction involving cytokines released by inflammatory cells, thedebatable influence of tubule epithelial-mesenchyme transition, and decreased removal of collagen due to inhibition of collagenolytic enzymes. Fibrosis appears as a slightly fibrillar, eosinophilic material in the interstitium ( Figure 1 and Figure 2 ). Fibrosis may result in progressive atrophy of the nephron in affected areas and/or dilation of renal tubules and Bowman’s space.
Recommendation:
If fibrosis is a primary change or is present with little or no inflammation, then it should be diagnosed and given a severity grade. When fibrosis is secondary to another process, such as inflammation, and both are present concurrently, the pathologist should use his or her judgment in deciding whether or not the fibrosis is prominent enough to warrant a separate diagnosis. Related Links: Kidney - Infarct Kidney - Inflammation
来源与引用
原始条目:https://ntp.niehs.nih.gov/atlas/nnl/urinary-system/kidney/Fibrosis
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. Fibrosis (kidney). LabSmart 中文版:
https://www.labsmart.cn/ntp/kidney-fibrosis.html
中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#kidney-fibrosis