# 淋巴细胞凋亡（Apoptosis Lymphocyte）

- 器官 / 系统：胸腺 / 免疫系统（thymus / immune-system）
- NTP 数据编号：ntp-0021
- 规范 URL：https://www.labsmart.cn/ntp/thymus-apoptosis-lymphocyte.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#thymus-apoptosis-lymphocyte
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/immune-system/thymus/ApoptosisLymphocyte
- 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
胸腺淋巴细胞凋亡可发生于啮齿类动物，作为淋巴细胞阳性和阴性选择的一部分（即生理性凋亡），或继发于应激诱导的肾上腺皮质功能亢进、生长激素水平降低和/或直接毒性（例如皮质类固醇、雌激素或环磷酰胺）。

## 病变描述（中文）
胸腺淋巴细胞凋亡可发生于啮齿类动物，作为淋巴细胞阳性和阴性选择的一部分（即生理性凋亡），或继发于应激诱导的肾上腺皮质功能亢进、生长激素水平降低和/或直接毒性（例如皮质类固醇、雌激素或环磷酰胺）。凋亡的特征是单个淋巴细胞皱缩、核染色质（核固缩）和细胞器浓缩，以及凋亡细胞碎裂成膜结合的凋亡小体，随后被巨噬细胞（可染小体巨噬细胞）吞噬（Figure 2，箭头）。大量可染小体巨噬细胞在胸腺皮质形成典型的“星空”外观（Figure 1，箭头）。胸腺淋巴细胞显著凋亡而无细胞再生会导致胸腺萎缩。淋巴细胞凋亡必须与胸腺淋巴细胞坏死相鉴别，尽管在某些化学物（例如地塞米松）作用下二者可同时发生。淋巴细胞坏死通常呈广泛分布或累及相邻细胞，且不与可染小体巨噬细胞相关；一般可见淡嗜酸性碎片、核固缩碎片和炎症。胸腺淋巴细胞大量坏死还可伴有炎症、出血和/或矿化。早期与治疗相关的淋巴细胞凋亡可能难以与年轻大鼠和小鼠生理性正常的低水平背景淋巴细胞丢失相区分。因此，必须与同期对照进行比较。

## 诊断与分级建议（NTP 共识，中文）
胸腺淋巴细胞凋亡可以是正常的。如果与同期对照相比增加，则应诊断淋巴细胞凋亡并分级。诊断应基于病理学家的判断。如果淋巴细胞凋亡和坏死同时发生，则应同时诊断这两种病变。

## 英文原文 · Comment
Apoptosis of thymic lymphocytes may occur in rodents as a part of positive and negative selection of lymphocytes (i.e., physiological apoptosis) or secondary to stress-induced adrenocortical hyperactivity, decreased levels of growth hormone, and/or direct toxicity (e.g., corticosteroids, estrogen, or cyclophosphamide). Apoptosis is characterized by shrinkage of individual lymphocytes, condensation of nuclear chromatin (pyknotic nuclei) and cytoplasmic organelles, and fragmentation of apoptotic cells into membrane-bound bodies (apoptotic bodies), which are subsequently phagocytized by macrophages (tingible-body macrophages) ( Figure 2 , arrows). Numerous tingible-body macrophages create a classic "starry sky" appearance in the thymic cortex ( Figure 1 , arrowheads). Significant apoptosis of thymic lymphocytes without cell regeneration leads to atrophy of the thymus. Apoptosis of lymphocytes must be differentiated from lymphocyte necrosis in the thymus, although they can occur together with some chemicals (e.g., dexamethasone). Necrosis of lymphocytes is typically widespread or affects contiguous cells and is not associated with tingible-body macrophages; there is generally pale eosinophilic debris, pyknotic nuclear debris, and inflammation. Massive necrosis of thymic lymphocytes may also be accompanied by inflammation, hemorrhage, and/or mineralization. Early treatment-related lymphocyte apoptosis may be difficult to differentiate from the low background lymphocyte loss that is physiologically normal in young rats and mice. Therefore, comparison with concurrent controls is necessary.

## 英文原文 · Recommendation
Lymphocyte apoptosis in the thymus can be normal. If increased compared with concurrent controls, lymphocyte apoptosis should be diagnosed and graded. Diagnosis should be made based on the judgment of the pathologist. If lymphocyte apoptosis and necrosis occur concurrently, both lesions should be diagnosed.

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_0454.jpg
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