# 肾小管细胞质空泡化（Renal Tubule Vacuolation Cytoplasmic）

- 器官 / 系统：肾脏 / 泌尿系统（kidney / urinary-system）
- NTP 数据编号：ntp-0176
- 规范 URL：https://www.labsmart.cn/ntp/kidney-renal-tubule-vacuolation-cytoplasmic.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#kidney-renal-tubule-vacuolation-cytoplasmic
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/urinary-system/kidney/RenalTubule-VacuolationCytoplasmic
- 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
细胞质空泡化（cytoplasmic vacuolation）的特征是肾小管上皮内出现透明空泡，而不伴有任何与变性相关的形态学改变（Figure 1）。

## 病变描述（中文）
细胞质空泡化（cytoplasmic vacuolation）的特征是肾小管上皮内出现透明空泡，而不伴有任何与变性相关的形态学改变（Figure 1）。在某些品系的雄性小鼠中，外层皮质肾小管通常存在细胞质空泡，但雌性小鼠或大鼠通常不存在。异常性或病理性空泡化可见于各肾小管节段和集合管的任何部位。更常见于近端曲小管上皮。空泡化可能与单个较大的囊泡（大囊泡性，macrovesicular）相关，也可能与数个较小的囊泡（微囊泡性，microvesicular）相关。具有渗透活性的化合物（如某些糖类）常导致“渗透性肾病（osmotic nephrosis）”，表现为细胞质空泡化。肾小管上皮的细胞质空泡化也可见于磷脂沉积诱导性化学物、环糊精（cyclodextrins）以及其他通过吞噬溶酶体（phagolysosomes）诱导空泡化的化学物。在大多数情况下，细胞质空泡化是可逆的。与自溶或固定不良相关的假性空泡化（artifactual vacuolation）常见于试验中死亡或濒死状态处死的动物。通常难以将肾小管毒性与假性改变区分开来。

## 诊断与分级建议（NTP 共识，中文）
正常情况下，雄性小鼠存在程度不等的皮质肾小管细胞质空泡化，不必作出诊断（见 Kidney - Renal Tubule - Cytoplasmic Alteration）。在雄性小鼠中，只有当空泡的数量和/或大小超过同期对照时，才应诊断细胞质空泡化。雌性小鼠以及雄性和雌性大鼠的细胞质空泡化，只要存在即应诊断。该诊断应仅限用于空泡存在而不伴有其他变性形态学特征的情况。应在病理学描述中说明受影响的肾小管部位及肾脏区域。凡作出该诊断时，均应对细胞质空泡化进行分级。假性空泡化不应诊断。相关链接：Kidney - Renal Tubule - Cytoplasmic Alteration

## 英文原文 · Comment
Cytoplasmic vacuolation is characterized by the presence of clear vacuoles in renal tubule epithelium in the absence of any morphologic changes associated with degeneration ( Figure 1 ). Cytoplasmic vacuoles are normally present in the outer cortical tubules of male mice in certain strains, but are not typically present in female mice or rats. Abnormal, or pathologic, vacuolation may be seen anywhere along the various tubule segments and collecting ducts. It is more commonly observed in the proximal convoluted tubule epithelium. Vacuolation may be associated with single, larger vesicles (macrovesicular) or may be associated with several smaller vesicles (microvesicular). Osmotically active compounds such as some sugars often result in "osmotic nephrosis," which appears as cytoplasmic vacuolation. Cytoplasmic vacuolation of renal tubule epithelium may also be seen with phospholipidosis-inducing chemicals, cyclodextrins, and other chemicals that induce vacuolation through phagolysosomes. Cytoplasmic vacuolation, in most cases, is reversible. Artifactual vacuolation, related to autolysis or poor fixation, is frequently observed in animals either dying on test or sacrificed in a moribund state. Often it becomes problematic to separate tubule toxicity from artifact.

## 英文原文 · Recommendation
Normally, male mice have variable cortical tubule cytoplasmic vacuolation and do not have to be diagnosed (see Kidney - Renal Tubule - Cytoplasmic Alteration ). In male mice, cytoplasmic vacuolation should be diagnosed only when the number and/or size of vacuoles is greater than that of the concurrent controls. Cytoplasmic vacuolation in female mice and male and female rats should be diagnosed whenever present. This diagnosis should be reserved for those cases where the vacuoles are present in the absence of other morphologic features of degeneration. The tubule location and portion of the kidney affected should be described in the pathology narrative. Whenever it is diagnosed, cytoplasmic vacuolation should be graded. Artifactual vacuolation should not be diagnosed. Related Links: Kidney - Renal Tubule - Cytoplasmic Alteration

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