肾乳头坏死Papilla Necrosis · 肾脏 · 泌尿系统 · NTP ntp-0164
诊断要点：肾乳头坏死应当诊断并给出严重程度分级。研究病理学家应运用其判断来决定与乳头坏死相关的继发性病变（如炎症）是否足够显著以需要单独诊断。
病变描述
肾乳头坏死是一种累及肾乳头尖端的特定病变。早期阶段表现为乳头尖端区域细胞轮廓丧失和染色亲和力丧失（Figure 1）。更严重的病例可能累及整个肾乳头坏死（Figure 2）。根据病变的慢性程度，可能可见尿路上皮增生、出血、水肿、炎症和矿化。坏死的乳头常脱落入肾盂并导致梗阻（Figure 3）。在脱落区域可能观察到再上皮化。炎症常见于坏死区域邻近，肾盂肾炎也可能与乳头坏死相关（Figure 4）。乳头坏死在化学物给药情况下报道较其他原因更为常见。在大鼠和小鼠中自发病例不常见。
诊断与分级建议（NTP 共识）
肾乳头坏死应当诊断并给出严重程度分级。研究病理学家应运用其判断来决定与乳头坏死相关的继发性病变（如炎症）是否足够显著以需要单独诊断。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 papillary necrosis is a specific entity involving the tip of the renal papilla. Early stages involve loss of cellular definition and loss of staining affinity in the area of the papillary tip ( Figure 1 ). More severe cases may involve necrosis of the entire renal papilla ( Figure 2 ). Depending on the chronicity of the lesion, urothelial hyperplasia, hemorrhage, edema, inflammation, and mineralization may be evident. Often the necrotic papilla will slough off into the renal pelvis and result in obstruction ( Figure 3 ). Re-epithelialization may be observed in sloughed areas. Inflammation is commonly observed adjacent to necrotic areas, and pyelonephritis may also be associated with papillary necrosis ( Figure 4 ). Papillary necrosis is more commonly reported with chemical administration than from other causes. Spontaneous cases are uncommon in the rat and mouse.
Recommendation：
Necrosis of the renal papilla should be diagnosed and given a severity grade. The study pathologist should use his or her judgment in deciding whether or not secondary lesions, such as inflammation, associated with papillary necrosis are 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/Papilla-Necrosis
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. Papilla Necrosis (kidney). LabSmart 中文版：
https://www.labsmart.cn/ntp/kidney-papilla-necrosis.html
中文图谱总页（可展开对照全部 595 条）：https://www.labsmart.cn/ntp-atlas.html#kidney-papilla-necrosis