# 窦内红细胞增多（Sinus Erythrocytosis）

- 器官 / 系统：淋巴结 / 免疫系统（lymph-node / immune-system）
- NTP 数据编号：ntp-0008
- 规范 URL：https://www.labsmart.cn/ntp/lymph-node-sinus-erythrocytosis.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#lymph-node-sinus-erythrocytosis
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/immune-system/lymph-node/SinusErythrocytosis
- 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
窦性红细胞增多症（sinus erythrocytosis）的特征是淋巴窦内存在红细胞（Figure 1，箭头）。

## 病变描述（中文）
窦性红细胞增多症（sinus erythrocytosis）的特征是淋巴窦内存在红细胞（Figure 1，箭头）。该病变通常是由于受累淋巴结引流器官或组织出血所致。急性期可能无反应。慢性病变中，可能出现噬红细胞现象（erythrophagocytosis）（Figure 2，箭头）、退变红细胞的血红蛋白结晶化，以及含铁血黄素色素在淋巴窦、窦组织细胞和髓索巨噬细胞内的蓄积。窦性红细胞增多症必须与血管扩张（angiectasis）、出血、充血、血管瘤和血管肉瘤相鉴别。窦性红细胞增多症与血管扩张的鉴别可能具有挑战性，因为扩张的淋巴管可类似于扩张的血管，且两者均衬以内皮。窦性红细胞增多症可与原发性出血相鉴别，因为血液局限于内皮衬覆的淋巴窦内，而未外渗至组织中。充血同样位于管腔内，但累及血管，血管可能扩张（血管扩张性）也可能不扩张。窦性红细胞增多症可累及整个淋巴结，这将其与血管瘤典型的边界清楚、紧密排列的扩张血管腔隙相区分。血管瘤的血管腔隙衬以内皮，但内皮细胞排列于薄或宽的胶原性间质上。窦性红细胞增多症不具有侵袭性，也不显示内皮细胞异型性，这将其与血管肉瘤相区分。窦性红细胞增多症还必须与安乐死（濒死期）或组织解剖（死后）相关的红细胞外渗相鉴别。调查该淋巴结引流区域内出血的区域可能有助于纳入/排除窦性红细胞增多症。

## 诊断与分级建议（NTP 共识，中文）
当存在该病变的生前证据（例如噬红细胞现象或引流区域出血）时，淋巴结窦性红细胞增多症应当被诊断并分级。如果淋巴结内红细胞外渗可归因于濒死期或死后伪影，则不应诊断。

## 英文原文 · Comment
Sinus erythrocytosis is characterized by the presence of erythrocytes within the lymphatic sinuses ( Figure 1 , arrow). This lesion generally occurs as a result of hemorrhage in organs or tissues drained by the affected node. Acutely, there may be no reaction. In chronic lesions, there may be erythrophagocytosis ( Figure 2 , arrow), crystallization of hemoglobin from degenerate erythrocytes, and accumulation of hemosiderin pigment within lymphatic sinuses, sinus histiocytes, and medullary cord macrophages. Sinus erythrocytosis must be differentiated from angiectasis, hemorrhage, congestion, hemangioma, and hemangiosarcoma. Differentiation of sinus erythrocytosis and angiectasis may be a challenge, since dilated lymphatic vessels can resemble dilated blood vessels and both are lined by endothelium. Sinus erythrocytosis can be differentiated from primary hemorrhage in that blood is confined to endothelial-lined lymphatic sinuses and not extravasated into the tissue. Congestion is also intraluminal but involves blood vessels that may or may not be dilated (angiectatic). Sinus erythrocytosis can occur throughout the lymph node, which differentiates it from the well-circumscribed, tightly packed, dilated vascular spaces typical of hemangioma. The vascular spaces of hemangioma are lined by endothelium, but endothelial cells are aligned on a thin or broad collagenous stroma. Sinus erythrocytosis is not invasive and does not demonstrate endothelial cell atypia, which differentiates it from hemangiosarcoma. Sinus erythrocytosis must be also differentiated from extravasations of erythrocytes associated with euthanasia (perimortem) or tissue dissection (postmortem). A survey for regions of hemorrhage in the drainage field for the node in question may help to rule in/out sinus erythrocytosis.

## 英文原文 · Recommendation
Sinus erythrocytosis in lymph nodes should be diagnosed and graded when antemortem evidence (e.g., erythrophagocytosis or hemorrhage in drainage field) for the lesion is present. It should not be diagnosed if extravasations of erythrocytes in a lymph node can be attributed to peri- or postmortem artifact.

## 配图
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