# 坏死（Necrosis）

- 器官 / 系统：舌 / 消化系统（tongue / alimentary-system）
- NTP 数据编号：ntp-0291
- 规范 URL：https://www.labsmart.cn/ntp/tongue-necrosis.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#tongue-necrosis
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/alimentary-system/tongue/Necrosis
- 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
坏死可继发于创伤、感染、血管炎或血栓形成，也可作为受试物的直接效应而发生（尤其是上皮坏死）。

## 病变描述（中文）
坏死可继发于创伤、感染、血管炎或血栓形成，也可作为受试物的直接效应而发生（尤其是上皮坏死）。坏死与溃疡的鉴别在于，溃疡是鳞状上皮缺失的区域，且病变穿过基底膜，暴露出其下的固有层。而在坏死时，坏死上皮仍附着于基底膜。坏死可累及舌的全层（Figure 1、Figure 2、Figure 3、Figure 4），尤其当病因为血管性时。除肌肉坏死外（Figure 2、Figure 4、Figure 5、Figure 6，箭头），舌被覆的鳞状上皮也可发生坏死（Figure 2、Figure 3，箭头），这取决于坏死的部位和范围。炎症常伴随坏死出现，所呈现的炎症类型取决于病程的慢性程度和病因。在 NTP 研究中，舌肌肉的病变并不常见。

## 诊断与分级建议（NTP 共识，中文）
坏死应当被诊断并给予严重程度分级。如果坏死累及舌的肌肉或多个组织，则诊断为“舌——坏死”。然而，如果坏死仅限于舌的上皮，则诊断应为“舌，上皮——坏死”。继发性病变，如炎症或出血，一般不应单独诊断，除非它们是病变的显著组成部分。如果坏死性病变符合梗死，则应诊断为“坏死”，但病理学描述中应说明该病变符合梗死。

## 英文原文 · Comment
Necrosis can occur secondary to trauma, infection, vasculitis, or thrombosis or as a direct effect of a test agent (particularly epithelial necrosis). Necrosis is differentiated from ulcer in that an ulcer is an area of loss of squamous epithelium that extends through the basement membrane, exposing the underlying lamina propria. In necrosis, the necrotic epithelium remains attached to the basement membrane. Necrosis may involve the full thickness of the tongue ( Figure 1 , Figure 2 , Figure 3 , and Figure 4 ), particularly when the etiology is vascular. In addition to muscle necrosis ( Figure 2 , Figure 4 , Figure 5 , and Figure 6 , arrows), the overlying squamous epithelium of the tongue can also be necrotic ( Figure 2 and Figure 3 , arrows), depending on the location and extent of necrosis. Inflammation often accompanies the necrosis, and the type of inflammation present depends on the chronicity and the etiology. Lesions are not common in the muscle of the tongue in NTP studies.

## 英文原文 · Recommendation
Necrosis should be diagnosed and given a severity grade. If the necrosis involves muscle or multiple tissues in the tongue, then it is diagnosed as "tongue - necrosis." However, if the necrosis is limited to the epithelium of the tongue, the diagnosis should be "tongue, epithelium - necrosis." Secondary lesions, such as inflammation or hemorrhage, generally should not be diagnosed separately unless they are prominent components of the lesion. If the necrotic lesion is consistent with an infarct, it should be diagnosed as "necrosis," but the pathology narrative should state the lesion is consistent with an infarct.

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_0177.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_0180.jpg

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