炎症Inflammation · 卵巢 · 雌性生殖系统 · NTP ntp-0516

依据美国国家毒理学计划(NTP)Nonneoplastic Lesion Atlas 整理 · 中文译文与诊断建议 · 仅供科研使用,不用于临床诊断

一句话结论:在NTP研究中,炎症有五个标准类别: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))。
诊断要点:卵巢 - 炎症:存在时应诊断并分级。诊断中应通过使用限定词指明炎症类型。继发于炎症的病变,如坏死、出血和水肿,除非严重程度 warrant,否则不应单独诊断,但应在病理叙述中描述。

病变描述

在NTP研究中,炎症有五个标准类别: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,主要浸润细胞是中性粒细胞(neutrophil),尽管也可能存在较少的巨噬细胞(macrophage)和淋巴细胞(lymphocyte)。还可能有水肿或充血(hyperemia)的证据。中性粒细胞也是化脓性炎症中的主要浸润细胞类型(Figure 1、Figure 2、Figure 3、Figure 4、Figure 5),但中性粒细胞聚集,且许多已变性(化脓性渗出物,化脓性 exudate)。渗出物中还可能存在细胞碎片(来自驻留细胞群和浸润白细胞)、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(plasma cell),以及可能的感染因子。肉眼上,这些病变以脓液存在为特征。渗出物周围组织可能含有成纤维细胞(fibroblast)、纤维结缔组织和混合性炎症细胞,取决于病变的慢性程度。脓肿在组织学上应诊断为化脓性炎症。淋巴细胞在慢性炎症中占主导地位(Figure 6、Figure 7)。淋巴细胞在慢性活动性炎症中也占主导地位(Figure 8、Figure 9),但也存在显著数量的中性粒细胞。两种病变均可能含有巨噬细胞。肉芽肿性炎症(Figure 10、Figure 11)是慢性炎症的另一种形式,但该诊断要求存在显著数量的聚集性、大型、活化巨噬细胞、上皮样巨噬细胞(epithelioid macrophage)或多核巨细胞(multinucleated giant cell)。炎症与细胞浸润的鉴别在于其他改变的存在,如水肿、出血、变性、坏死或其他组织损伤证据。肉芽肿性卵巢炎症的特征是多灶性、边界清楚、大小不一且形状不规则的嗜酸性泡沫状巨噬细胞簇,周围环绕数量不等的多核巨细胞和淋巴细胞(Figure 10、Figure 11)。这种类型的炎症可见于发情前期(proestrus)对照动物的黄体(corpus luteum)中,因此该病变仅在以下情况下才应诊断:在动情周期(estrous cycle)的其他阶段见到、似乎位于黄体之外、或在处理动物中比对照动物更严重。导致炎症的卵巢感染通常为上行性,经由阴道和子宫腔。原因可能与动物饲养设施的环境因素和清洁度有关。卵巢感染可见于由多种细菌引起的全身性感染。然而,自身免疫性卵巢炎症已在胸腺切除小鼠中得到证实,可能涉及T淋巴细胞介导的机制。

诊断与分级建议(NTP 共识)

卵巢 - 炎症:存在时应诊断并分级。诊断中应通过使用限定词指明炎症类型。继发于炎症的病变,如坏死、出血和水肿,除非严重程度 warrant,否则不应单独诊断,但应在病理叙述中描述。如果炎症继发于另一病变(例如坏死或肿瘤形成),除非严重程度 warrant,否则不应单独诊断,但应在叙述中描述为原发病变成分。相关链接:卵巢 - 细胞浸润

图谱

炎症(卵巢)组织学图谱 1
图 1 · 炎症 · 来源:NTP NNL Atlas
炎症(卵巢)组织学图谱 2
图 2 · 炎症 · 来源:NTP NNL Atlas

英文原文

展开 NTP 官方英文描述与建议

Comment:
In NTP studies, there are five standard categories of inflammation: acute, suppurative, chronic, chronic active, and granulomatous. In acute inflammation , the predominant infiltrating cell is the neutrophil, though fewer macrophages and lymphocytes may also be present. There may also be evidence of edema or hyperemia. The neutrophil is also the predominant infiltrating cell type in suppurative inflammation ( Figure 1 , Figure 2 , Figure 3 , Figure 4 and Figure 5 ), but the neutrophils are aggregated, and many are degenerate (suppurative exudate). Cell debris, both from the resident cell populations and from infiltrating leukocytes, and 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 pus. The tissue surrounding the exudate may contain fibroblasts, fibrous connective tissue, and mixed inflammatory cells, depending on the chronicity of the lesion. Abscesses should be diagnosed histologically as suppurative inflammation. Lymphocytes predominate in chronic inflammation ( Figure 6 and Figure 7 ). Lymphocytes also predominate in chronic active inflammation ( Figure 8 and Figure 9 ), but there are also a significant number of neutrophils. Both lesions may contain macrophages. Granulomatous inflammation ( Figure 10 and Figure 11 ) is another form of chronic inflammation, but this diagnosis requires the presence of a significant number of aggregated, large, activated macrophages, epithelioid macrophages, or multinucleated giant cells. Inflammation is differentiated from cellular infiltrates by the presence of other changes, such as edema, hemorrhage, degeneration, necrosis, or other evidence of tissue damage. Granulomatous ovarian inflammation is characterized by multifocal, well-circumscribed, variably sized and irregularly shaped eosinophilic clusters of foamy macrophages, surrounded by variable numbers of multinucleated giant cells and lymphocytes ( Figure 10 and Figure 11 ). This type of inflammation can be seen in corpora lutea in control animals during proestrus, so this lesion should be diagnosed only if it is seen during other phases of the estrous cycle, if it appears to be outside of corpora lutea, or if it is more severe in the treated animals than in controls. Ovarian infections resulting in inflammation are generally ascending, through the vagina and uterine cavity. The cause may be related to environmental factors and cleanliness in the animal housing facility. Ovarian infections may be seen with systemic infections caused by a variety of bacteria. However, autoimmune ovarian inflammation has been demonstrated in thymectomized mice, possibly involving a T-lymphocyte-mediated mechanism.

Recommendation:
Ovary - Inflammation should be diagnosed and graded whenever present. The type of inflammation should be indicated in the diagnosis by use of a qualifier. Lesions secondary to inflammation, such as necrosis, hemorrhage, and edema, should not be diagnosed separately unless warranted by severity but should be described in the pathology narrative. If the inflammation is secondary to another lesions (e.g., necrosis or neoplasia), it should not be diagnosed separately unless warranted by severity but should be described in the narrative as a component of the primary lesion. Related Links: Ovary - Infiltration Cellular

来源与引用

原始条目:https://ntp.niehs.nih.gov/atlas/nnl/reproductive-system-female/ovary/Inflammation

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. Inflammation (ovary). LabSmart 中文版: https://www.labsmart.cn/ntp/ovary-inflammation.html

中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#ovary-inflammation

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