腺泡萎缩Acinus Atrophy · 前列腺 · 雄性生殖系统 · NTP ntp-0450
诊断要点:前列腺萎缩应当诊断并分级,治疗相关的加重应在病理叙述中指明。如有可能,应确定受累的叶并在组织识别中指明(例如,prostate, dorsolateral lobe, acinus - atrophy, severe)。
病变描述
前列腺萎缩(prostatic atrophy)表现为腺体皱缩,显微镜下特征为腺泡(acini)体积减小、被覆上皮细胞变薄、分泌物质稀少以及间质突出度增加(星号,Figure 4)。Figure 1、Figure 2 展示正常前列腺的背侧叶(dorsolateral lobe)以供比较。一般而言,萎缩累及前列腺所有叶。抑制促性腺激素类固醇和垂体激素可导致睾丸及附属生殖器官(包括前列腺)萎缩。5α-还原酶(5α-reductases)是参与前列腺内睾酮转化为其生物活性形式双氢睾酮(dihydrotestosterone)的酶,其抑制剂如非那雄胺(finasteride)和依普甾胺(epristeride)已知可诱导前列腺萎缩。同样,抗雄激素物质如羟基氟他胺(hydroxyflutamide)可引起前列腺萎缩。雌激素使腹侧前列腺和精囊的腺上皮体积减小、纤维肌性间质增加。锌指转录因子 Egr 家族(如 Egr4 和 Egr1)的缺陷,如在 Egr4-Egr1 双突变小鼠中,导致前列腺、睾丸、附睾和精囊萎缩。自发性前列腺萎缩是一种与年龄相关的病变。
诊断与分级建议(NTP 共识)
前列腺萎缩应当诊断并分级,治疗相关的加重应在病理叙述中指明。如有可能,应确定受累的叶并在组织识别中指明(例如,prostate, dorsolateral lobe, acinus - atrophy, severe)。当已知时,应指明双侧受累,并根据受累更严重的叶确定严重程度分级。
图谱


英文原文
展开 NTP 官方英文描述与建议
Comment:
Prostatic atrophy represents glandular shrinkage and is microscopically characterized by reduction in the size of acini, attenuation of lining epithelial cells, scanty secretory material, and increased stromal prominence (asterisks, Figure 4 ). Figure 1 and Figure 2 represent the dorsolateral lobe of normal prostate for comparison. In general, atrophy involves all lobes of the prostate. Inhibition of gonadal steroid and pituitary hormones results in atrophy of testes and accessory sex organs, including prostate. Inhibitors of 5α-reductases, enzymes involved in intraprostatic conversion of testosterone to its biologically active form dihydrotestosterone, such as finasteride and epristeride, are known to induce atrophy of prostate. Similarly, antiandrogenic substances such as hydroxyflutamide cause prostatic atrophy. Estrogens decrease the volume of the glandular epithelium and increase the fibromuscular stroma in both ventral prostate and seminal vesicle. Deficiency of the Egr family of zinc finger transcription factors such as Egr4 and Egr1, as in Egr4-Egr1 double-mutant mice, leads to atrophy of prostate, testis, epididymis, and seminal vesicle. Spontaneous prostatic atrophy is an age-related lesion.
Recommendation:
Prostatic atrophy should be diagnosed and graded, and treatment-associated exacerbation should be indicated in the pathology narrative. The affected lobe(s) should be identified if possible and indicated in the tissue identification (e.g., prostate, dorsolateral lobe, acinus - atrophy, severe). When known, bilateral involvement should be indicated and the severity grade determined by the more severely affected lobe.
来源与引用
原始条目:https://ntp.niehs.nih.gov/atlas/nnl/reproductive-system-male/prostate/Acinus-Atrophy
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. Acinus Atrophy (prostate). LabSmart 中文版:
https://www.labsmart.cn/ntp/prostate-acinus-atrophy.html
中文图谱总页(可展开对照全部 595 条):https://www.labsmart.cn/ntp-atlas.html#prostate-acinus-atrophy