# 炎症（Inflammation）

- 器官 / 系统：齐姆巴尔腺 / 特殊感觉系统（zymbals-gland / special-senses-system）
- NTP 数据编号：ntp-0362
- 规范 URL：https://www.labsmart.cn/ntp/zymbals-gland-inflammation.html
- 中文图谱总页锚点：https://www.labsmart.cn/ntp-atlas.html#zymbals-gland-inflammation
- 原始出处：https://ntp.niehs.nih.gov/atlas/nnl/special-senses-system/zymbals-gland/Inflammation
- 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
慢性耵聍腺炎（Zymbal's gland inflammation）（Figure 1、Figure 2）的特征是间质内单核细胞、巨噬细胞及少量中性粒细胞浸润。

## 病变描述（中文）
慢性耵聍腺炎（Zymbal's gland inflammation）（Figure 1、Figure 2）的特征是间质内单核细胞、巨噬细胞及少量中性粒细胞浸润。更广泛的化脓性耵聍腺炎（Figure 3）的特征是大片、有时为包裹性的坏死碎屑区域，其中混有和/或边缘环绕着积聚的退变炎症细胞（尤其是中性粒细胞）。在NTP研究中，炎症分为五个标准类别：急性（急性（acute））、化脓性（化脓性（suppurative））、慢性（慢性（chronic））、慢性活动性（慢性活动性（chronic-active））和肉芽肿性（肉芽肿性（granulomatous））。急性炎症中，主要浸润细胞为中性粒细胞，但也可能存在少量巨噬细胞和淋巴细胞。还可能有水肿或充血的表现。化脓性炎症中，主要浸润细胞类型同样为中性粒细胞，但在化脓性炎症中，中性粒细胞聚集成团，其中许多已退变（化脓性渗出物）。渗出物中还可能存在来自 resident 细胞群和浸润白细胞的细胞碎屑、含纤维蛋白的蛋白性液体、少量巨噬细胞、偶见的淋巴细胞或浆细胞，以及可能的感染因子。肉眼观察，这些病变以脓液存在为特征。渗出物周围组织中可能存在成纤维细胞、纤维结缔组织和混合性炎症细胞，具体取决于病变的慢性程度。慢性炎症以淋巴细胞为主。慢性活动性炎症同样以淋巴细胞为主，但慢性活动性炎症中还存在大量中性粒细胞。两种病变均可能含有巨噬细胞。肉芽肿性炎症是慢性炎症的另一种形式，但该诊断要求存在大量聚集的、大的活化巨噬细胞、上皮样巨噬细胞或多核巨细胞。炎症与细胞浸润的鉴别在于是否存在其他改变，如水肿、出血、变性、坏死或其他组织损伤的证据。

## 诊断与分级建议（NTP 共识，中文）
耵聍腺炎应当诊断并赋予严重程度分级。诊断中应包含适当的类型修饰词，以表明所存在的炎症类型（急性、慢性等）。当继发于其他所见（如耵聍腺囊肿、增生或肿瘤）时，炎症不应单独诊断，除非其严重程度足以支持独立诊断，但可在病理学描述中加以描述。

## 英文原文 · Comment
Chronic Zymbal's gland inflammation ( Figure 1 and Figure 2 ) is characterized by interstitial infiltrates of mononuclear cells, macrophages, and few neutrophils. More extensive suppurative Zymbal's gland inflammation ( Figure 3 ) is characterized by extensive, sometimes encapsulated areas of necrotic debris admixed and/or bordered by accumulations of degenerate inflammatory cells (especially neutrophils). In NTP studies, there are five standard categories of inflammation: acute, suppurative, chronic, chronic-active, and granulomatous. In acute inflammation, the predominant infiltrating cell is the neutrophil, though fewer macrophages and lymphocytes may also be present. There may also be evidence of edema or hyperemia. The neutrophil is also the predominant infiltrating cell type in suppurative inflammation, however, in suppurative inflammation, the neutrophils are aggregated and many of them are degenerate (suppurative exudate). Cell debris, both from the resident cell populations and infiltrating leukocytes, proteinaceous fluid containing fibrin, fewer macrophages, occasional lymphocytes or plasma cells, and, possibly, an infectious agent may also be present in within the exudate. Grossly, these lesions would be characterized by the presence of pus. In the tissue surrounding the exudate, there may be fibroblasts, fibrous connective tissue, and mixed inflammatory cells, depending on the chronicity of the lesion. Lymphocytes predominate in chronic inflammation. Lymphocytes also predominate in chronic-active inflammation, but in chronic-active inflammation, there are also a significant number of neutrophils. Both lesions may contain macrophages. Granulomatous inflammation is another form of chronic inflammation, but this diagnosis requires the presence of a significant number of aggregated, large, activated macrophages, epithelioid macrophages, or multinucleated giant cells. Inflammation is differentiated from cellular infiltrates by the presence of other changes, such as edema, hemorrhage, degeneration, necrosis, or other evidence of tissue damage.

## 英文原文 · Recommendation
Zymbal's gland inflammation should be diagnosed and assigned a severity grade. An appropriate type modifier should be included in the diagnosis to indicate the type of inflammation present (acute, chronic, etc.). When secondary to other findings (e.g., Zymbal's gland cyst, hyperplasia, or neoplasia), inflammation should not be diagnosed separately unless warranted by severity, but can be described in the pathology narrative.

## 配图
- https://www.labsmart.cn/ntp-atlas-images/ntp_1053.jpg
- https://www.labsmart.cn/ntp-atlas-images/ntp_1056.jpg

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