色素Pigment · 肝 · 肝胆系统 · NTP ntp-0421

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:内源性和外源性色素均可出现于肝细胞,但色素沉着更常发生于Kupffer细胞。色素在门管区可能较为显著。
诊断要点:即使使用一系列特殊染色,在组织学切片中确定性鉴定色素往往仍很困难。因此,诊断为“色素”最为恰当。

病变描述

内源性和外源性色素均可出现于肝细胞,但色素沉着更常发生于Kupffer细胞。色素在门管区可能较为显著。肝脏色素的鉴定通常需要多种特殊染色。不同色素常含有一定量的铁,因此用Prussian blue染色会呈现不同程度的阳性。Figure 1中,色素沉积于聚集的Kupffer细胞簇中,其严重程度分级为3+(中度(moderate))。Figure 2、Figure 3显示Kupffer细胞及肝细胞中均有色素沉积的证据。色素沉积主要位于小叶中央,严重程度分级为3+(中度)。Figure 4中,色素沉积主要位于肝细胞内,呈全小叶性分布。

诊断与分级建议(NTP 共识)

即使使用一系列特殊染色,在组织学切片中确定性鉴定色素往往仍很困难。因此,诊断为“色素”最为恰当。病理学描述应说明色素沉着的形态学特征、小叶分布、受累细胞类型以及与色素沉积可能相关的任何伴随组织学改变。病理学家也可在病理学描述中对存在的色素类型作出推测。应根据色素存在的相对数量进行严重程度分级。

图谱

色素(肝)组织学图谱 1
图 1 · 色素 · 来源:NTP NNL Atlas
色素(肝)组织学图谱 2
图 2 · 色素 · 来源:NTP NNL Atlas

英文原文

展开 NTP 官方英文描述与建议

Comment:
Both endogenous and exogenous pigment can occur in hepatocytes, but pigmentation occurs more often in Kupffer cells. Pigment may be prominent in portal areas. Identification of hepatic pigment typically requires multiple special stains. Different pigments frequently contain some iron and will thus have variable positivity with Prussian blue stain. In Figure 1 , pigment is deposited in clusters of aggregated Kupffer cells, which was given a severity grade of 3+ (moderate). Figure 2 and Figure 3 show evidence of pigment deposition in Kupffer cells as well as in hepatocytes. The pigment deposition is primarily centrilobular and was given a severity grade of 3+ (moderate). In Figure 4 , the pigment deposition is primarily within hepatocytes and has a panlobular distribution.

Recommendation:
Definitive pigment identification is often difficult in histologic sections, even with a battery of special stains. Therefore, a diagnosis of “pigment” is most appropriate. The pathology narrative should describe the morphologic features of the pigmentation, the lobular distribution, the cell type affected, and any accompanying histologic changes that might be associated with the pigment deposition. The pathologist may also speculate in the pathology narrative as to the type of pigment present. A severity grade should be assigned based on the relative amounts of pigment present.

来源与引用

原始条目:https://ntp.niehs.nih.gov/atlas/nnl/hepatobiliary-system/liver/Pigment

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. Pigment (liver). LabSmart 中文版: https://www.labsmart.cn/ntp/liver-pigment.html

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

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