坏死Necrosis · 淋巴结 · 免疫系统 · NTP ntp-0002
诊断要点:淋巴结坏死应予以诊断并赋予严重程度分级。如果淋巴结坏死继发于其他病变(如肿瘤形成、炎症),除非严重程度足以支持,否则不应诊断,但应在病理学描述中予以描述。
病变描述
淋巴结坏死(necrosis of the lymph nodes)在啮齿类动物中是一种不常见的病变;然而,它可由血流阻塞(梗死)、肿瘤形成、感染因子(如真菌、细菌)或异物(如受试物)所诱发。该病变的特征是细胞肿胀伴染色质聚集、核碎裂或核溶解,导致细胞核溶解、细胞裂解以及大量颗粒状嗜酸性物质积聚(Figure 1、Figure 2,箭头)。淋巴结坏死通常伴有炎症(Figure 2,箭头head),并且根据严重程度和慢性程度,还可伴有纤维化、出血和/或矿化。坏死应与淋巴细胞凋亡相鉴别,后者的特征是细胞皱缩、核固缩以及淋巴细胞碎裂为膜结合的(凋亡)小体,随后被巨噬细胞(可染小体巨噬细胞)吞噬。
诊断与分级建议(NTP 共识)
淋巴结坏死应予以诊断并赋予严重程度分级。如果淋巴结坏死继发于其他病变(如肿瘤形成、炎症),除非严重程度足以支持,否则不应诊断,但应在病理学描述中予以描述。
图谱


英文原文
展开 NTP 官方英文描述与建议
Comment:
Necrosis of the lymph nodes is an uncommon lesion in rodents; however, it may be induced by obstruction of blood flow (infarction), neoplasia, an infectious agent (e.g., fungi, bacteria), or foreign body (e.g., test article). This lesion is characterized by cellular swelling with chromatin clumping, karyorrhexis, or karyolysis, leading to dissolution of nuclei, cell lysis, and accumulation of abundant granular eosinophilic material ( Figure 1 and Figure 2 , arrows). Lymph node necrosis is generally accompanied by inflammation ( Figure 2 , arrowhead) and can also be accompanied by fibrosis, hemorrhage, and/or mineralization, depending on severity and chronicity. Necrosis should be differentiated from lymphocyte apoptosis, which is characterized by cell shrinkage, nuclear pyknosis, and fragmentation of lymphocytes into membrane-bound (apoptotic) bodies that are subsequently phagocytized by macrophages (tingible-body macrophages).
Recommendation:
Necrosis of the lymph node should be diagnosed and assigned a severity grade. If lymph node necrosis is present secondary to another lesion (e.g., neoplasia, inflammation), it should not be diagnosed 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/immune-system/lymph-node/Necrosis
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. Necrosis (lymph-node). LabSmart 中文版:
https://www.labsmart.cn/ntp/lymph-node-necrosis.html
中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#lymph-node-necrosis