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Here is simple edema, or fluid collection within tissues. This is "pitting" edema because, on physical examination, you can press your finger into the skin and soft tissue and leave a depression.

图示:凹陷性水肿

液体在组织间隙积聚形成水肿。体格检查时,手指按压相应皮肤和软组织,手指离开后凹陷不能立即恢复。

This example of a fluid collection, a friction blister of the skin, is an almost trivial example of edema.

皮肤过度摩擦,使皮下液体积聚,这样的水肿对机体的影响很小。

This example of edema with inflammation is not trivial at all: there is marked laryngeal edema such that the airway is narrowed. This is life-threatening. Thus, fluid collections can be serious depending upon their location.

图示:喉头水肿

炎症发生的喉头水肿对机体的影响较大,引起气道狭窄,甚至威胁生命。水肿对机体的影响与发生部位密切相关。

Here is an example of fluid collection into a body cavity, or an effusion. This is a right pleural effusion (in a baby). Note the clear, pale yellow appearance of the fluid. This is a serous effusion. Extravascular fluid collections can be classified as follows:
小儿胸腔积液,液体呈浅黄*色,渗出严重。血管外液体的积聚分为以下几种类型:

Exudate: extravascular fluid collection that is rich in protein and/or cells. Fluid appears grossly cloudy.
渗出:渗出液中富含蛋白和/或细胞。渗出液较混浑。

Transudate: extravascular fluid collection that is basically an ultrafiltrate of plasma with little protein and few or no cells. Fluid appears grossly clear.
漏出:属于血浆的超滤液,含有少量蛋白,极少量细胞,液体澄清。

Effusions into body cavities can be further described as follows:
进入体腔的液体分为以下几类:

  • Serous: a transudate with mainly edema fluid and few cells.
    浆液:稀薄,含少量细胞。

  • Serosanguinous: an effusion with red blood cells.
    血性浆液:含较多红细胞。

  • Fibrinous (serofibrinous): fibrin strands are derived from a protein-rich exudate.
    纤维蛋白:交织的纤维蛋白源于富含蛋白的渗出液。

  • Purulent: numerous PMN's are present. Also called "empyema" in the pleural space.
    化脓:有大量嗜中性粒细胞,在胸膜腔积聚又称为积脓。

This radiograph demonstrates fluid in the left pleural cavity. This pleural effusion could result from a transudate (serous effusion) or from hemorrhage (hemothorax), or serous fluid tinged with blood (serosanguinous effusion). This effusion could be chylous (which is quite rare). A purulent exudate at this location may be termed empyema. An air-fluid level is seen in the stomach below the dome of the left diaphragmatic leaf.

图示:X线示左胸膜腔积液
胸膜腔积液的源于浆液性渗出、血胸、血性浆液。此种积液少见。如果在胸膜腔脓性渗出物聚积称为脓胸。

Here is an example of bilateral pleural effusions. Note that the fluid appears reddish, because there has been hemorrhage into the effusion. This is a serosanguinous effusion.

图示:双侧胸膜腔积液

可见红色血性液体,此为血性浆液渗出的结果。

The milky white fluid shown here in the peritoneal cavity represents a chylous ascites. This is an uncommon fluid accumulation that can be due to blockage of lymphatic drainage, in this case by a malignant lymphoma involving the mesentery and retroperitoneum.

图示:腹膜腔乳糜性腹水,呈乳白色。这是一种特殊的液体积聚,发生于淋巴管阻塞,通常是恶性淋巴瘤累及肠系膜和腹膜后腔。

Exudation of a protein-rich fluid into a cavity leads to a transudate. The fibrin in this fluid can form a fibrinous exudate on the surfaces. Here, the pericardial cavity has been opened to reveal a fibrinous pericarditis with strands of stringy pale fibrin between visceral and parietal pericardium.

渗出液中蛋白质含量较高,会导致体腔积液。如果以纤维素为主,会导致粘膜表面的纤维素性炎症。图示纤维素性心包炎,在心包脏层和壁层之间可见白色绒毛状的纤维素。

Microscopically, the fibrinous exudate is seen to consist of pink strands of fibrin jutting from the pericardial surface at the upper left. Below this, there are a few scattered inflammatory cells.

镜下可在左上方可见渗出的粉红色束状纤维突出于心包膜表面。其下面可见散在的炎细胞。

This yellow-green exudate on the surface of an inflamed, hyperemic (erythematous) bowel mucosa consists of many neutrophils along with fibrin and amorphous debris from dying cells.

炎性充血的肠粘膜表面可见黄绿色渗出物,由在病灶处纤维和坏死细胞碎片周围有许多中性粒细胞组成。


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