淀粉样物质Amyloid · 肺 · 呼吸系统 · NTP ntp-0104

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:淀粉样物质(Amyloid)(Figure 1、Figure 2、Figure 3、Figure 4)是指不溶性、细胞外和/或细胞内的蛋白质,在组织学上表现为无定形、嗜酸性、无细胞成分的物质。
诊断要点:由于该病变具有生物学重要性,肺-淀粉样物质(Lung - Amyloid)一旦出现即应作出诊断并赋予严重程度分级。

病变描述

淀粉样物质(Amyloid)(Figure 1、Figure 2、Figure 3、Figure 4)是指不溶性、细胞外和/或细胞内的蛋白质,在组织学上表现为无定形、嗜酸性、无细胞成分的物质。刚果红(Congo red)染色呈阳性,在偏振光下具有特征性的苹果绿双折射。淀粉样物质的沉积可为局灶性(focal)、多灶性(multifocal)或弥漫性(diffuse)。累及血管壁并不少见,但也可见于支气管周围区域。严重病例中,肺实质可被破坏。约90%的沉积物由错误折叠蛋白聚集形成的淀粉样纤维构成,10%的沉积物由糖胺聚糖、载脂蛋白E和血清淀粉样P组成。淀粉样变性在某些品系中作为背景性改变被发现,如CD-1小鼠。肺淀粉样变性是老龄啮齿动物的自发性病变,可局限于肺,也可为累及脾、肾、肝及其他器官的全身性淀粉样变性的组成部分。它也可能与慢性炎症相关。由于肺内淀粉样物质沉积与外源性物质给药之间的关联尚未见报道,淀粉样物质沉积通常被认为是背景性所见。然而,它可能是一些动物发病或死亡的原因,并可影响研究的结果。

诊断与分级建议(NTP 共识)

由于该病变具有生物学重要性,肺-淀粉样物质(Lung - Amyloid)一旦出现即应作出诊断并赋予严重程度分级。淀粉样物质沉积的部位应在诊断中通过部位修饰词加以标明。任何继发性病变,如坏死或变性,除非严重程度确有必要,否则不应单独诊断,但应在病理学叙述中加以描述。

图谱

淀粉样物质(肺)组织学图谱 1
图 1 · 淀粉样物质 · 来源:NTP NNL Atlas
淀粉样物质(肺)组织学图谱 2
图 2 · 淀粉样物质 · 来源:NTP NNL Atlas

英文原文

展开 NTP 官方英文描述与建议

Comment:
Amyloid ( Figure 1 , Figure 2 , Figure 3 , and Figure 4 ) refers to insoluble, extracellular and/or intracellular proteins that appear as amorphous, eosinophilic, acellular material histologically. It stains positively with Congo red stain and has a characteristic apple green birefringence under polarized light. Deposition of amyloid can be focal, multifocal, or diffuse. Involvement of vascular walls is not uncommon, but it may also be seen in peribronchial areas. In severe cases, the pulmonary parenchyma may be effaced. Approximately 90% of the deposits consist of amyloid fibrils formed by the aggregation of misfolded proteins, and 10% of the deposits consist of glycosaminoglycans, apolipoprotein E, and serum amyloid P. Amyloidosis is found as a background change in some strains, such as CD-1 mice. Pulmonary amyloidosis is a spontaneous lesion in aging rodents and may be localized to the lung, or it may be a component of systemic amyloidosis involving spleen, kidney, liver, and other organs. It may also be associated with chronic inflammation. Since an association between amyloid deposition in the lung and xenobiotic administration has not been reported, amyloid deposition is generally considered a background finding. It may, however, be the cause of morbidity or mortality in some animals and can affect the outcome of a study.

Recommendation:
Because this lesion is biologically important, Lung - Amyloid should be diagnosed and assigned a severity grade whenever present. The location of the amyloid deposits should be indicated in the diagnosis by using a site modifier. Any secondary lesions, such as necrosis or degeneration, should not be diagnosed separately unless warranted by severity but should be described in the pathology narrative.

来源与引用

原始条目:https://ntp.niehs.nih.gov/atlas/nnl/respiratory-system/lung/Amyloid

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. Amyloid (lung). LabSmart 中文版: https://www.labsmart.cn/ntp/lung-amyloid.html

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

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