弥漫性增生Hyperplasia Diffuse · 甲状旁腺 · 内分泌系统 · NTP ntp-0056

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:甲状旁腺增生(parathyroid hyperplasia)可为局灶性(focal)或弥漫性(diffuse),在大鼠中发生率低,在小鼠中罕见。
诊断要点:只要观察到增生,就应作出诊断并给出严重程度分级。如果双侧甲状旁腺均受累,诊断应限定为双侧性,严重程度分级应基于受累较重的一侧腺体。

病变描述

甲状旁腺增生(parathyroid hyperplasia)可为局灶性(focal)或弥漫性(diffuse),在大鼠中发生率低,在小鼠中罕见。弥漫性增生可能与肾功能衰竭及长期饮食中钙和/或磷失衡有关,且通常为双侧性。弥漫性增生表现为细胞密度均匀增加,由细胞肥大和增生共同所致。发生弥漫性增生时,正常的细胞巢和细胞索发生改变,其中增生性细胞巢体积增大最为明显。严重增生通常会导致甲状旁腺肉眼可见增大,但如果组织学切片中的组织取样不佳,则可能在组织学上难以判断。与甲状旁腺腺瘤的鉴别在于,腺瘤表现为腺体内一个离散的膨胀性病变,通常为单侧,并伴有邻近实质受压。

诊断与分级建议(NTP 共识)

只要观察到增生,就应作出诊断并给出严重程度分级。如果双侧甲状旁腺均受累,诊断应限定为双侧性,严重程度分级应基于受累较重的一侧腺体。如果病理学家认为增生与肾脏疾病相关,应在病理学叙述中注明。其他可能与增生相关的病变,如胃或肾脏矿化,也应在病理学叙述中加以评论。

图谱

弥漫性增生(甲状旁腺)组织学图谱 1
图 1 · 弥漫性增生 · 来源:NTP NNL Atlas
弥漫性增生(甲状旁腺)组织学图谱 2
图 2 · 弥漫性增生 · 来源:NTP NNL Atlas

英文原文

展开 NTP 官方英文描述与建议

Comment:
Parathyroid hyperplasia can be focal or diffuse and occurs in low incidence in rats and rarely in mice. Diffuse hyperplasia may be associated with renal failure and long-term dietary imbalance of calcium and/or phosphorus and is usually bilateral. Diffuse hyperplasia presents as a uniform increase in cellularity due to combined hypertrophy and hyperplasia. With diffuse hyperplasia, the normal cellular nests and cords are altered, with increased size of hyperplastic nests being most obvious. Severe hyperplasia will usually result in a grossly enlarged parathyroid but may be difficult to determine histologically if the tissue in the histologic sections is not well sampled. Distinction from parathyroid adenoma is based on the adenoma appearing as a discrete expansile lesion, usually unilateral, within the gland and with compression of adjacent parenchyma.

Recommendation:
Hyperplasia should be diagnosed and given a severity grade whenever observed. If both parathyroids are involved, the diagnosis should be qualified as bilateral and the severity grade should be based on the more severely affected gland. If the pathologist feels the hyperplasia is associated with renal disease, it should be noted in the pathology narrative. Other lesions that may be associated with the hyperplasia, such as gastric or renal mineralization, should also be commented on in the pathology narrative.

来源与引用

原始条目:https://ntp.niehs.nih.gov/atlas/nnl/endocrine-system/parathyroid-gland/HyperplasiaDiffuse

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. Hyperplasia Diffuse (parathyroid-gland). LabSmart 中文版: https://www.labsmart.cn/ntp/parathyroid-gland-hyperplasia-diffuse.html

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

先天性囊肿合胞体巨细胞局灶性增生异位组织纤维化血管扩张