# 组织细胞性细胞浸润（Infiltration Cellular Histiocyte）

- 器官 / 系统：肺 / 呼吸系统（lung / respiratory-system）
- NTP 数据编号：ntp-0109
- 规范 URL：https://www.labsmart.cn/ntp/lung-infiltration-cellular-histiocyte.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#lung-infiltration-cellular-histiocyte
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/respiratory-system/lung/InfiltrationCellularHistiocyte
- 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
吸入毒物后的反应常包括肺泡内肺泡巨噬细胞的积聚。肺泡巨噬细胞的积聚也是坏死反应的一部分，并可能与肺肿瘤或肺泡/细支气管增生相关。

## 病变描述（中文）
吸入毒物后的反应常包括肺泡内肺泡巨噬细胞的积聚。肺泡巨噬细胞的积聚也是坏死反应的一部分，并可能与肺肿瘤或肺泡/细支气管增生相关。可自发观察到局灶性（focal）组织细胞浸润，最常见于老年动物的胸膜下区域。肺泡组织细胞浸润由肺泡内巨噬细胞的积聚构成。巨噬细胞可表现为活化状态（增大，胞质呈泡沫状）或静息状态。尽管该病变通常仅限于肺泡巨噬细胞的积聚（Figure 1、Figure 3、Figure 4、Figure 5、Figure 6），但可能存在相关所见，如少量其他炎性细胞（淋巴细胞或中性粒细胞）、极轻微（minimal）水肿、出血或肺泡间隔增厚（Figure 2）。此外，巨噬细胞可含有色素，可能为含铁血黄素，或与受试物一致的外来物质（Figure 5、Figure 6）。必须将组织细胞浸润与炎症相鉴别，后者有时可能较为困难。一般而言，组织细胞浸润的特征是肺泡组织细胞数量增多，而无（或仅有极轻微）其他炎症证据（例如，存在其他类型的炎性细胞、水肿、出血、肺泡间隔增厚）。

## 诊断与分级建议（NTP 共识，中文）
肺 - 细胞浸润，组织细胞在大多数情况下应被诊断并给予严重程度分级。如果组织细胞含有受试物，则应单独诊断为外来物质并分级（见肺 - 外来物质）。如果肺泡巨噬细胞被认为是炎症反应的组成部分，则应诊断炎症而非组织细胞浸润。与肿瘤明确相关的肺泡组织细胞积聚不应记录，而应在叙述中描述为继发于肿瘤。肺泡巨噬细胞的小型胸膜下积聚在大鼠中常作为背景病变见到。如果组织细胞浸润是与受试物给药相关的弥漫性（diffuse）改变，而局灶性（focal）、胸膜下（背景）聚集可能使发病率统计数据产生偏倚，则慢性研究中非受试物相关的胸膜下病灶要么不应记录（即视为在正常范围内），要么可使用修饰词单独记录（例如，细胞浸润，组织细胞，局灶性或细胞浸润，组织细胞，弥漫性）。在某些情况下，最好对两种病变均作出诊断。例如，如果从低剂量组的肺泡组织细胞浸润（无炎症改变）到高剂量组的伴有炎症区域的肺泡组织细胞浸润存在连续过程，则可能需要对两种病变均作出诊断，以充分捕捉受试物的效应。病理学家在记录这些病变时需要运用其判断力，并且必须注意在整个研究过程中保持一致性。相关链接：肺 - 外来物质

## 英文原文 · Comment
Responses to inhaled toxicants often include the accumulation of alveolar macrophages within alveoli. Accumulation of alveolar macrophages is also part of the response to necrosis and may be associated with pulmonary neoplasms or alveolar/bronchiolar hyperplasia. Focal histiocytic infiltrates may be observed spontaneously, most often in subpleural regions of older animals. Alveolar histiocytic infiltrates consist of intra-alveolar accumulations of macrophages. The macrophages can appear activated (enlarged with foamy cytoplasm) or quiescent. Though the lesion is often limited to the accumulation of alveolar macrophages ( Figure 1 , Figure 3 , Figure 4 , Figure 5 , and Figure 6 ), associated findings may be present, such as a few other inflammatory cells (lymphocytes or neutrophils), minimal edema, hemorrhage, or thickening of alveolar septa ( Figure 2 ). Also, the macrophages may contain pigment, which may represent hemosiderin, or foreign material consistent with the test article ( Figure 5 and Figure 6 ). Histiocytic infiltration must be differentiated from inflammation, which can sometimes be difficult. In general, histiocytic infiltration is characterized by increased numbers of alveolar histiocytes with no (or minimal) other evidence of inflammation (e.g., the presence of other types of inflammatory cells, edema, hemorrhage, alveolar septal thickening).

## 英文原文 · Recommendation
Lung - Infiltration cellular, Histiocyte should be diagnosed and given a severity grade in most cases. If the histiocytes contain the test agent, it should be diagnosed and graded separately foreign material (see Lung - Foreign Material ). If the alveolar macrophages are considered to be a component of an inflammatory response, then inflammation should be diagnosed in lieu of histiocytic infiltration. Accumulations of alveolar histiocytes that are clearly associated with a neoplasm should not be recorded but should be described in the narrative as being secondary to the neoplasm. Small, subpleural accumulations of alveolar macrophages are frequently seen as background lesions in rats. If histiocytic infiltration is a diffuse change related to test article administration, and focal, subpleural (background) aggregates might skew incidence statistics, then either the non-test-article-related subpleural foci in chronic studies should not be recorded (i.e., considered to be within normal limits), or they may be recorded separately using modifier (e.g., Infiltration cellular, Histiocyte, Focal or Infiltration cellular, Histiocyte, Diffuse). In some cases, it may be best to diagnose both lesions. For example, if there is a continuum from alveolar histiocyte infiltration (with no inflammatory changes) in the low-dose groups to alveolar histiocyte infiltration with areas of inflammation in the high-dose groups, then it may be necessary to diagnose both lesions to fully capture the effects of the test article. The pathologist will need to use his or her judgment in recording these lesions and must take care to maintain consistency throughout the study. Related Links: Lung - Foreign Material

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