肝细胞结节性增生Hepatocyte - Hyperplasia Nodular · 肝 · 肝胆系统 · NTP ntp-0413

依据美国国家毒理学计划(NTP)Nonneoplastic Lesion Atlas 整理 · 中文译文与诊断建议 · 仅供科研使用,不用于临床诊断

一句话结论:结节性增生(nodular hyperplasia)可作为慢性肝毒性的后遗症出现,也可发生于其他方面正常的肝脏。
诊断要点:无论何时出现,这种慢性、增生性肝脏反应均应作出诊断并给出严重程度分级,严重程度取决于肝脏受累范围。

病变描述

结节性增生(nodular hyperplasia)可作为慢性肝毒性的后遗症出现,也可发生于其他方面正常的肝脏。它也可能继发于大颗粒细胞淋巴瘤(单核细胞白血病)。它通常由多个肝细胞增生结节组成,结节之间被卵圆细胞带、胶原沉积和塌陷的肝小叶分隔(Figure 1、Figure 2)。还可能存在数量不等的单核白细胞。结节性增生导致肝脏大体变形,并保留明显扭曲的肝小叶结构。存在当前或既往肝毒性的证据提示再生性发病机制。

诊断与分级建议(NTP 共识)

无论何时出现,这种慢性、增生性肝脏反应均应作出诊断并给出严重程度分级,严重程度取决于肝脏受累范围。相关病变,如炎症、纤维化或肝细胞坏死,若其严重程度足以支持,应单独作出诊断。其关联可在病理学描述中说明。当前或既往肝毒性应在病理学描述中予以评述。

图谱

肝细胞结节性增生(肝)组织学图谱 1
图 1 · 肝细胞结节性增生 · 来源:NTP NNL Atlas
肝细胞结节性增生(肝)组织学图谱 2
图 2 · 肝细胞结节性增生 · 来源:NTP NNL Atlas

英文原文

展开 NTP 官方英文描述与建议

Comment:
Nodular hyperplasia can occur as a sequela to chronic hepatotoxicity or may arise in an otherwise normal liver. It may also be secondary to large granular cell lymphoma (mononuclear cell leukemia). It usually consists of multiple nodules of hepatocellular hyperplasia separated by bands of oval cells, collagen deposition, and collapsed hepatic lobules ( Figure 1 and Figure 2 ). Varying numbers of mononuclear leukocytes may also be present. Nodular hyperplasia results in gross distortion of the liver with retention of a markedly distorted hepatic lobular structure. Evidence of current or history of antecedent hepatotoxicity indicates a regenerative pathogenesis.

Recommendation:
Whenever present, this chronic, proliferative, hepatic response should be diagnosed and given a severity grade, with severity dependent on the extent of liver involvement. Associated lesions, such as inflammation, fibrosis, or hepatocellular necrosis, should be diagnosed separately if warranted by the severity of these lesions. Their association can be made clear in the pathology narrative. Current or antecedent hepatotoxicity should be commented on in the pathology narrative.

来源与引用

原始条目:https://ntp.niehs.nih.gov/atlas/nnl/hepatobiliary-system/liver/Hepatocyte%E2%80%93HyperplasiaNodular

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. Hepatocyte - Hyperplasia Nodular (liver). LabSmart 中文版: https://www.labsmart.cn/ntp/liver-hepatocyte-hyperplasia-nodular.html

中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#liver-hepatocyte-hyperplasia-nodular

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