# 淀粉样物质（Amyloid）

- 器官 / 系统：脾脏 / 免疫系统（spleen / immune-system）
- NTP 数据编号：ntp-0034
- 规范 URL：https://www.labsmart.cn/ntp/spleen-amyloid.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#spleen-amyloid
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/immune-system/spleen/Amyloid
- 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
淀粉样变性（amyloidosis）是一种系统性疾病，其特征为无定形蛋白质样物质在多种组织（包括脾、肝和肾）的细胞外沉积。

## 病变描述（中文）
淀粉样变性（amyloidosis）是一种系统性疾病，其特征为无定形蛋白质样物质在多种组织（包括脾、肝和肾）的细胞外沉积。在小鼠脾脏中，淀粉样物质沉积于红髓及白髓邻近区域（边缘区）（Figure 1、Figure 2，箭头）。当该病变严重时，可导致白髓萎缩（Figure 1，箭头头）。淀粉样物质经刚果红（Congo red）染色并在偏振光下观察时，可呈现苹果绿色双折射，也可通过免疫组织化学方法检测。淀粉样变性在B6C3F1小鼠和大鼠中罕见。小鼠自发性淀粉样变性的发生率随年龄增长而升高，并可能受多种因素影响，包括繁育来源、饮食、环境和炎症。在小鼠中，自发性年龄相关（老年性）淀粉样变性已被认为与淀粉样载脂蛋白A2（ApoA2）沉积相关，而炎症诱导的淀粉样变性则与血清淀粉样蛋白A（一种急性期蛋白）相关。ApoA2是小鼠血清高密度脂蛋白的主要成分。

## 诊断与分级建议（NTP 共识，中文）
脾脏中淀粉样物质无论何时出现，均应作出诊断并赋予严重程度分级。由于淀粉样变性是一种系统性疾病，其他组织（如肝和肾）也应评估是否存在淀粉样物质。继发性病变，如实质细胞坏死或变性，除非因严重程度需要或对研究结果的解释具有重要意义，否则不应单独诊断，但应在病理学叙述中描述。

## 英文原文 · Comment
Amyloidosis is a systemic disease characterized by the extracellular deposition of amorphous proteinaceous material in multiple tissues, including spleen, liver, and kidney. In the spleen of mice, amyloid is deposited in the red pulp and adjacent to the white pulp (marginal zone) ( Figure 1 and Figure 2 , arrows). When this lesion is severe, it can result in white pulp atrophy ( Figure 1 , arrowhead). Amyloid can be identified by apple-green birefringence when stained with Congo red and visualized under polarized light, or it can be detected immunohistochemically. Amyloidosis is rare in B6C3F1 mice and rats. The incidence of spontaneous amyloidosis in mice increases with age and may be influenced by various factors, including breeding origin, diet, environment, and inflammation. In mice, spontaneous age-associated (senile) amyloidosis has been associated with amyloid apolipoprotein A2 (ApoA2) deposition, whereas inflammatory-induced amyloidosis has been correlated with serum amyloid A (an acute-phase protein). ApoA2 is a major constituent of serum high-density lipoprotein in mice.

## 英文原文 · Recommendation
Whenever present, amyloid in the spleen should be diagnosed and assigned a severity grade. Since amyloidosis is a systemic disease, other tissues, such as liver and kidney, should also be evaluated for amyloid. Secondary lesions, such as necrosis or degeneration of parenchymal cells, should not be diagnosed separately unless warranted by severity or important for interpretation of study results, but should be described in the pathology narrative.

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_0417.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_0420.jpg

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