# 水肿（Edema）

- 器官 / 系统：骨骼肌 / 骨骼肌肉系统（skeletal-muscle / musculoskeletal-system）
- NTP 数据编号：ntp-0589
- 规范 URL：https://www.labsmart.cn/ntp/skeletal-muscle-edema.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#skeletal-muscle-edema
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/musculoskeletal-system/skeletal-muscle/Edema
- 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
骨骼肌中的水肿与其他组织中的水肿一样，在组织学上表现为间质组织被无定形至纤维状、透明至淡嗜酸性物质所扩张，这些物质分隔并环绕单个肌纤维（Figure 1、Figure 2、Figure 3、Figure 4）。

## 病变描述（中文）
骨骼肌中的水肿与其他组织中的水肿一样，在组织学上表现为间质组织被无定形至纤维状、透明至淡嗜酸性物质所扩张，这些物质分隔并环绕单个肌纤维（Figure 1、Figure 2、Figure 3、Figure 4）。重要的是要将因水肿而扩张的间质间隙与正常组织中因固定或切片伪影而形成的间隙区分开来（Figure 5）。由伪影导致的分离在肌纤维和肌束之间缺乏淡嗜酸性纤维状物质的存在。虽然水肿可以作为原发性病变发生（Figure 1、Figure 2、Figure 3、Figure 4），但它最常见的是继发于坏死和炎症；出血区域常伴有水肿。肌内水肿可见于自身免疫性疾病，如多发性肌炎和皮肌炎；轻度损伤；感染性肌炎；亚急性失神经支配；骨筋膜室综合征；以及横纹肌溶解症；它也可作为肌肉运动期间及运动后短暂的生理性表现而被观察到。

## 诊断与分级建议（NTP 共识，中文）
当肌内水肿是唯一或原发性病变时，应予以诊断并分级。在肌内水肿为继发性病变（例如继发于炎症）的情况下，除非因严重程度而有必要，否则不应单独记录，但应在病理学叙述中加以描述。

## 英文原文 · Comment
Edema in skeletal muscle, as in other tissues, is histologically identified by the expansion of interstitial tissue by amorphous to fibrillar, clear to pale eosinophilic material that separates and surrounds individual myofibers ( Figure 1 , Figure 2 , Figure 3 , and Figure 4 ). It is important to distinguish interstitial spaces that are expanded due to edema from those created in normal tissue as a result of fixation or sectioning artifact ( Figure 5 ). Separation as a result of artifact lacks the presence of pale eosinophilic fibrillar material between muscle fibers and bundles. While edema can occur as a primary lesion ( Figure 1 , Figure 2 , Figure 3 , and Figure 4 ), it most commonly occurs secondary to necrosis and inflammation; regions of hemorrhage are often accompanied by edema. Intramuscular edema can be seen in association with autoimmune conditions, such as polymyositis and dermatomyositis; mild injuries; infectious myositis; subacute denervation; compartment syndrome; and rhabdomyolysis; it can also be seen as a transient, physiologic finding during and briefly following muscle exercise.

## 英文原文 · Recommendation
When intramuscular edema is the sole or primary lesion, it should be diagnosed and graded. In instances where intramuscular edema is a secondary lesion (e.g., to inflammation), it should not be recorded separately unless warranted by severity but should be described within the pathology narrative.

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_0540.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_0542.jpg

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