炎症Inflammation · 肾脏 · 泌尿系统 · NTP ntp-0158
诊断要点:当肾脏炎症是原发性病变或严重到足以需要单独诊断时,应进行诊断并分级。诊断应包括部位修饰词(例如,间质、肾小管、肾小球)和炎症类型(例如,急性、慢性、慢性活动性)。
病变描述
在NTP研究中,根据存在的优势炎症细胞类型,炎症分为五个标准类别: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))。在肾脏-肾小球肾炎中。肾小管炎症(肾小管炎)(Figure 1、Figure 2)可能与多种原因有关,这些原因可能包括晶体沉积、下尿路延伸(肾盂肾炎)、感染过程、慢性进行性肾病、既往梗死或直接化学物质给药。肾小管炎症的特征是肾小管腔、上皮或两者内存在炎症细胞。炎症也可局限于肾盂(Figure 3、Figure 4、Figure 5、Figure 6)或间质(Figure 7、Figure 8)。肾盂炎症通常源于与局部感染相关的状况,这些感染从下尿路上升并延伸至肾乳头、髓质和皮质。然而,也可能见到无下尿路受累的肾盂炎症。炎症可能有多种原因。肾盂炎症通常为急性或化脓性,在肾盂周围组织中可见更慢性的病变。病理学家偶尔用于描述类似状况的另一个诊断术语是“肾盂肾炎”,其强调肾脏受累以及肾盂炎症。在显著(marked)病例中可能注意到微脓肿,这是由于上行感染或同时发生的败血症性感染。肾乳头溃疡和/或坏死可能作为肾盂炎症的结果而发生。在更慢性的病例中,常注意到反应性尿路上皮和/或乳头状上皮增生。间质炎症,即对多种原因所致组织损伤的细胞反应,在啮齿类动物的肾脏中可能频繁观察到。慢性间质炎症常被视为慢性进行性肾病的一个组成部分(见Kidney - Nephropathy, 慢性 Progressive)。
诊断与分级建议(NTP 共识)
当肾脏炎症是原发性病变或严重到足以需要单独诊断时,应进行诊断并分级。诊断应包括部位修饰词(例如,间质、肾小管、肾小球)和炎症类型(例如,急性、慢性、慢性活动性)。肾小球中的炎症反应应诊断为肾小球肾炎,并在单独的文件中涵盖(见Kidney - Glomerulonephritis)。病理学家应运用其判断来决定与炎症相关的坏死或出血等继发性病变是否足够显著以需要单独诊断。作为慢性进行性肾病组成部分的炎症不应单独诊断。相关链接:Kidney - Fibrosis Kidney - Glomerulonephritis Kidney - Infarct Kidney - Nephropathy, 慢性(chronic) Progressive
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英文原文
展开 NTP 官方英文描述与建议
Comment:
In NTP studies, there are five standard categories of inflammation, according to the predominant inflammatory cell type present: acute, suppurative, chronic, chronic active, and granulomatous. In Kidney - Glomerulonephritis ). Renal tubule inflammation (tubulitis) ( Figure 1 and Figure 2 ) may be associated with a number of causes that may include the deposition of crystals, extension from the lower urinary tract (pyelonephritis), infectious processes, chronic progressive nephropathy, previous infarction, or direct chemical administration. Tubule inflammation is characterized by the presence of inflammatory cells within the tubule lumen, epithelium, or both. Inflammation can also be localized to the renal pelvis ( Figure 3 , Figure 4 , Figure 5 , and Figure 6 ) or the interstitium ( Figure 7 and Figure 8 ). Renal pelvis inflammation usually arises from conditions related to localized infections, which ascend from the lower urinary tract and extend into the renal papilla, medulla, and cortex. However, renal pelvis inflammation without lower urinary tract involvement may also be seen. There may be a number of causes for inflammation. Renal pelvis inflammation typically is acute or suppurative, with more chronic lesions noted in peripelvic tissues. Another diagnostic term occasionally used by pathologists to describe a similar condition is "pyelonephritis," which emphasizes renal involvement along with pelvis inflammation. Microabscesses may be noted in marked cases, due to either an ascending infection or a coinciding septicemic infection. Renal papillary ulceration and/or necrosis may occur as a result of renal pelvis inflammation. Reactive urothelial and/or papillary epithelial hyperplasia are often noted in more chronic cases. Interstitial inflammation, a cellular reaction to tissue injury from a variety of causes, may be observed frequently in the kidney of rodents. Chronic interstitial inflammation is often seen as a component of chronic progressive nephropathy (see Kidney - Nephropathy, Chronic Progressive ).
Recommendation:
Inflammation in the kidney should be diagnosed and graded when it is a primary lesion or is severe enough to warrant a separate diagnosis. The diagnosis should include a site modifier (e.g., interstitium, renal tubule, glomerulus) and the type of inflammation (e.g., acute, chronic, chronic active). Inflammatory reactions in the glomerulus should be diagnosed as glomerulonephritis and are covered in a separate document (see Kidney - Glomerulonephritis ). The pathologist should use his or her judgment in deciding whether or not secondary lesions such as necrosis or hemorrhage associated with inflammation are prominent enough to warrant a separate diagnosis. Inflammation as a component of chronic progressive nephropathy should not be diagnosed separately. Related Links: Kidney - Fibrosis Kidney - Glomerulonephritis Kidney - Infarct Kidney - Nephropathy, Chronic Progressive
来源与引用
原始条目:https://ntp.niehs.nih.gov/atlas/nnl/urinary-system/kidney/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 (kidney). LabSmart 中文版:
https://www.labsmart.cn/ntp/kidney-inflammation.html
中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#kidney-inflammation