肺气肿Emphysema · 肺 · 呼吸系统 · NTP ntp-0113
诊断要点:肺-肺气肿应作出诊断并赋予严重程度分级。相关病变,如炎症,应单独诊断。若该病变被认为是人为假象,则不应诊断肺气肿,但可录入组织备注以说明此情况。
病变描述
肺气肿(pulmonary emphysema,Figure 1、Figure 2)是指终末细支气管远端肺泡气腔扩大,伴肺泡间隔破坏。根据时间范围不同,可能存在也可能不存在肺泡间隔活动性破坏的证据。肺泡间隔的损伤不可逆。病变可为局灶性(focal)或多灶性(multifocal),并可累及多个肺叶。肺气肿应与剖检时肺内灌注固定液过度充盈所致的变化相鉴别,后者可能难以区分;然而,肺过度充盈可导致血管周围间隙人为增大。肺气肿可由多种原因引起。多种蛋白酶(如猪胰弹性蛋白酶、木瓜蛋白酶和人中性粒细胞弹性蛋白酶)、内毒素、香烟烟雾及其他因素已被用于在啮齿类动物中构建人类肺气肿模型。炎性病变可通过阻塞气道、允许吸入但阻碍呼出(“球阀效应”)而导致肺过度充气;这必须与真性肺气肿相鉴别。据报道,仙台病毒(Sendai virus)可在新生大鼠中引起肺气肿,推测是上皮坏死和炎症的结果,不过由于现代动物饲养管理措施,该病原体感染现已罕见。
诊断与分级建议(NTP 共识)
肺-肺气肿应作出诊断并赋予严重程度分级。相关病变,如炎症,应单独诊断。若该病变被认为是人为假象,则不应诊断肺气肿,但可录入组织备注以说明此情况。相关链接:肺-支气管扩张(Lung - Bronchiectasis)
图谱


英文原文
展开 NTP 官方英文描述与建议
Comment:
Pulmonary emphysema ( Figure 1 and Figure 2 ) refers to enlargement of the alveolar airspaces distal to the terminal bronchioles with destruction of alveolar septa. Depending on the time frame, there may or may not be evidence of active destruction of the septa. The damage to the septa is irreversible. It can be focal or multifocal and may involve multiple lobes. Emphysema should be differentiated from the effects of overfilling the lungs with fixative at necropsy, which can be difficult; however, overfilling of the lungs can result in artifactually increased perivascular space. Emphysema can result from a number of causes. Various proteases (e.g., porcine pancreatic elastase, papain, and human neutrophils elastase), endotoxin, cigarette smoke, and other agents have been used in rodents to model emphysema in humans. Inflammatory lesions may produce overinflation of the lungs by obstructing airways and allowing inhalation but hindering exhalation (the "ball and valve effect"); this must be differentiated from true emphysema. Sendai virus has been reported to cause emphysema in neonatal rats, presumably as a result of epithelial necrosis and inflammation, though infection by this agent is now rare due to modern animal husbandry practices.
Recommendation:
Lung - Emphysema should be diagnosed and assigned a severity grade. Associated lesions, such as inflammation, should be diagnosed separately. If the lesion is considered to be an artifact, emphysema should not be diagnosed, but a tissue note may be entered to that effect. Related Links: Lung - Bronchiectasis
来源与引用
原始条目:https://ntp.niehs.nih.gov/atlas/nnl/respiratory-system/lung/Emphysema
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. Emphysema (lung). LabSmart 中文版:
https://www.labsmart.cn/ntp/lung-emphysema.html
中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#lung-emphysema