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Pathology Department of Dalian Medical University
第四章 炎症 病理学与法医学教研室 Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
第三节 慢性炎症 Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
慢性炎症以增生变化为主，变质和渗出较轻。 分类 一般慢性炎症:非特异性慢性炎 肉芽肿性炎症 Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
主要原因 1、微生物持续存在，毒力较弱，又不是很容易就消灭掉。 2、长期暴露，接触毒性因子，如矽肺就是长期吸入SiO2粉尘的结果。 3、对自身组织产生免疫反应，自身免疫病如类风湿，系统性红斑狼疮。 Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
一、一般慢性炎症的病理变化特点 —非特异性增生性炎 一般特点： 炎症病灶内浸润的细胞主要是淋巴细胞、浆细胞、巨噬细胞。 主要由炎症细胞引起组织破坏 常有较明显的纤维结缔组织、血管、上皮细胞、腺体和实质细胞的增生，以替代损伤组织 病例3 Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
后果 炎性息肉 炎性假瘤 本质是慢性炎症，形成肿块，形态上－肉眼检查X光检查象肿瘤和肿瘤难以区分，叫炎性假瘤。最常见的部位是肺和眼眶。 发生在肺一个肿块，多被X光科诊断为肺癌 Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
二、慢性肉芽肿性炎 －特异性增生性炎 1、特点：形成肉芽肿。 2、肉芽肿是由渗出的单核细胞和以局部增生的巨噬细胞形成的境界清楚的结节状病灶。 3、肉芽肿性炎：以肉芽肿形成为基本特点的炎症。 Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
常见病因 1.细菌感染 2.螺旋体感染 3.真菌和寄生虫感染 4.异物 5.原因不明 Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
分类： 1、异物肉芽肿：由于异物不易被消化， 长期刺激形成的慢性炎症。 2、感染性肉芽肿 3、原因不明的肉芽肿 肉芽肿主要成分 上皮样细胞 多核巨细胞 Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
举例 结核结节 典型：中心为干酪样坏死，周围为放射状排列的上皮样细胞，并可见Langhans巨细胞，在向外围大量浸润的淋巴细胞，结节周围还可见纤维结缔组织包绕。 Pathology Department of Dalian Medical University
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Pathology Department of Dalian Medical University
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