# 炎症（Inflammation）

- 器官 / 系统：淋巴结 / 免疫系统（lymph-node / immune-system）
- NTP 数据编号：ntp-0007
- 规范 URL：https://www.labsmart.cn/ntp/lymph-node-inflammation.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#lymph-node-inflammation
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/immune-system/lymph-node/Inflammation
- 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
炎症细胞可见于淋巴结，其原因可能是给予刺激性受试化合物、对原发性淋巴细胞坏死的反应，或对感染因子或异物的反应。

## 病变描述（中文）
炎症细胞可见于淋巴结，其原因可能是给予刺激性受试化合物、对原发性淋巴细胞坏死的反应，或对感染因子或异物的反应。炎症细胞也可见于引流炎症部位的淋巴结，此时应诊断原发病灶，并在相关（引流）淋巴结中诊断“细胞浸润（infiltration, cellular）”。在NTP研究中，炎症的五个标准类别为急性（急性（acute））、化脓性（化脓性（suppurative））、慢性（慢性（chronic））、慢性活动性（慢性 active）和肉芽肿性（肉芽肿性（granulomatous））。在急性炎症中，中性粒细胞是主要的浸润细胞，但也可能存在较少的巨噬细胞和淋巴细胞。水肿或充血可能明显。中性粒细胞也是化脓性炎症中的主要细胞类型，但中性粒细胞聚集，其中许多发生变性（化脓性渗出物）（Figure 1、Figure 2）。渗出物中还可能存在来自驻留细胞群和浸润白细胞的细胞碎片；含纤维蛋白的蛋白性液体、较少的巨噬细胞、偶见的淋巴细胞或浆细胞；以及可能的感染因子。肉眼观察，这些病变的特征是存在渗出物。在渗出物周围的组织中，可能存在成纤维细胞、纤维结缔组织和混合性炎症细胞，取决于病变的慢性程度。淋巴细胞在慢性炎症中占主导地位。淋巴细胞在慢性活动性炎症中也占主导地位，但也可能存在大量中性粒细胞。慢性和慢性活动性炎症可能含有巨噬细胞。肉芽肿性炎症是慢性炎症的另一种形式，但该诊断要求存在大量聚集的、大的、活化的巨噬细胞（Figure 3、Figure 4）、上皮样巨噬细胞和/或多核巨细胞。巨噬细胞胞质内可能含有含铁血黄素或脂褐素色素或难以降解的物质。淋巴结炎症可伴有淋巴样增生或萎缩以及浆细胞增生。

## 诊断与分级建议（NTP 共识，中文）
淋巴结炎症存在时，应诊断并分级。“脓（pus）”和“脓肿（abscess）”一词仅应作为肉眼诊断使用。“慢性活动性（慢性（chronic） active）”可用于描述同时具有急性和慢性炎症成分的病变。在引流炎症和坏死部位的淋巴结中发现的炎症细胞应诊断为“细胞浸润（infiltration, cellular）”，并与淋巴结原发性炎症相区分。相关病变，如坏死或出血，除非因严重程度而有必要，不应单独诊断，但应在病理学叙述中描述。

## 英文原文 · Comment
Inflammatory cells can be found in lymph nodes as a result of administration of an irritating test compound, in response to primary lymphocyte necrosis, or as a response to an infectious agent or foreign body. Inflammatory cells can also be found in lymph nodes draining sites of inflammation, in which case the primary lesion should be diagnosed and "infiltration, cellular" should be diagnosed in the associated (draining) lymph node. In NTP studies, the five standard categories of inflammation are acute, suppurative, chronic, chronic active, and granulomatous. In acute inflammation , the neutrophil is the predominant infiltrating cell, though fewer macrophages and lymphocytes may also be present. Edema or hyperemia may be evident. The neutrophil is also the predominant cell type in suppurative inflammation , but the neutrophils are aggregated, and many of them are degenerate (suppurative exudate) ( Figure 1 and Figure 2 ). Cell debris from both the resident cell populations and infiltrating leukocytes; proteinaceous fluid containing fibrin, fewer macrophages, occasional lymphocytes, or plasma cells; and, possibly, an infectious agent may also be present within the exudate. Grossly, these lesions would be characterized by the presence of exudate. In the tissue surrounding the exudate, there may be fibroblasts, fibrous connective tissue, and mixed inflammatory cells, depending on the chronicity of the lesion. Lymphocytes predominate in chronic inflammation . Lymphocytes also predominate in chronic active inflammation , but there may also be a significant number of neutrophils. Chronic and chronic active inflammation may contain macrophages. Granulomatous inflammation is another form of chronic inflammation, but this diagnosis requires the presence of a significant number of aggregated, large, activated macrophages ( Figure 3 and Figure 4 ), epithelioid macrophages, and/ or multinucleated giant cells. Macrophages may contain cytoplasmic hemosiderin or lipofuscin pigment or poorly degradable substances. Lymphoid hyperplasia or atrophy and plasma cell hyperplasia may occur in association with nodal inflammation.

## 英文原文 · Recommendation
When present, lymph node inflammation should be diagnosed and graded. The terms "pus" and "abscess" should be used as gross diagnoses only. "Chronic active" can be used to describe lesions with components of both acute and chronic inflammation. Inflammatory cells found in lymph nodes draining sites of inflammation and necrosis should be diagnosed as "infiltration, cellular" and distinguished from primary inflammation of the lymph node. Associated lesions, such as necrosis or hemorrhage, should not be diagnosed separately unless warranted by severity, but should be described in the pathology narrative.

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