第四章 炎症演示文稿.ppt

多种细胞成分增生伴纤维化的炎性肿块。 多见于肺和眼眶。 血管改变 炎症水肿 慢性炎症细胞浸润 Tumor-like proliferation of local tissues (parenchymal, stromal, even inflammatory cells) resulting from chronic inflammation It is not a real tumor Occur in the orbit, lung, liver and spleen Chronic Inflammation In idiopathic orbital inflammation (orbital inflammatory pseudotumor), the orbital fat is replaced by fibrosis. Note the chronic inflammation, accompanied in this case by eosinophils. 是一种特殊的增生性炎，形成肉芽肿。 肉芽肿是由巨噬细胞及其演化的细胞呈局限性浸润和增生所形成的境界清楚的结节状病灶。 上皮样细胞 多核巨细胞-Langhans巨细胞，异物型巨细胞 细菌感染 螺旋体感染 真菌和寄生虫感染 异物 结节病 Examples of Diseases with Granulomatous Inflammation Disease Cause Tissue Reaction Tuberculosis Mycobacterium tuberculosis Noncaseating tubercle (granuloma prototype): a focus of epithelioid cells, rimmed by fibroblasts, lymphocytes, histiocytes, occasional giant cells ? ? Caseating tubercle: central amorphous granular debris, loss of all cellular detail; acid-fast bacilli Leprosy Mycobacterium leprae Acid-fast bacilli in macrophages; noncaseating granulomas Syphilis Treponema pallidum Gumma: microscopic to grossly visible lesion, enclosing wall of histiocytes; plasma cell infiltrate; central cells are necrotic without loss of cellular outline Cat-scratch disease Gram-negative bacillus Rounded or stellate granuloma containing central granular debris and recognizable neutrophils; giant cells uncommon Sarcoidosis Unknown etiology Noncaseating granulomas with abundant activated macrophages Crohn disease (inflammatory bowel disease) Immune reaction against intestinal bacterial, self-antigens Occasional noncaseating granulomas in wall of intestine, with dense chronic inflammatory infiltrate With a poor immune response to the agents producing granulomatous inflammation, there can be extensive spread of infection with the production of a miliary pattern of granulomas, as seen here in the lung of a patient with miliary tuberculosis. The 1 to 2 mm granulomas are scattered around like millet seeds (millet is a type of