Chronic Inflammation | 慢性炎症 | Chronic changes are the result of repetitive or sustained tissue damage due to trauma, ischemia, toxins, infection, or autoimmune processes. Features include the following: ● Increased vascularity and/or fibrosis ● Tissue destruction or obliteration of normal structures ● Lymphocytes, macrophages, plasma cells, eosinophils | 慢性改变是由于创伤、缺血、毒素、感染或自身免疫过程造成的重复性或持续性组织损伤的结果。包括如下特征： ●血管增多和/或纤维化 ●正常组织结构破坏或消失 ●淋巴细胞、巨噬细胞、浆细胞、嗜酸性粒细胞 | What is a macrophage? The precursor is a circulating monocyte, part of the myeloid lineage of blood cells . The monocyte leaves the circulation and becomes a tissue macrophage. It can differentiate into organ-specific resident macrophages, such as microglia, Kupffer cells, and alveolar macrophages. It can also go to an area of inflammation and become activated, participating in the immune response. Activated macrophages are also called histiocytes and may be “epithelioid,” as in a granuloma, and “foamy,” as in lipid-laden (xanthomatous), hemosiderin-laden, or full of mucin or melanin. Finally, macrophages can acquire multiple nuclei to become a Langerhans（此处应该是Langhans） giant cell (ring of nuclei) or a foreign-body type giant cell (scattered nuclei). | 巨噬细胞是什么？前体是一种循环的单核细胞，是血细胞中髓系的一部分。单核细胞离开循环系统，成为组织中的巨噬细胞。它可以分化为器官特异性的巨噬细胞（土著居民），如小胶质细胞、Kupffer细胞和肺泡巨噬细胞。它也可以进入炎症区域并被激活，参与免疫应答。活化的巨噬细胞也被称为组织细胞，可能是“上皮样细胞”，如肉芽肿；也可能是“泡沫细胞”，如富含脂质（黄色瘤样）、含铁血黄素或富含黏蛋白或黑色素。最后，巨噬细胞可获得多个细胞核，成为朗罕巨细胞（细胞核环状分布）或异物巨细胞（细胞核散乱无章分布散乱核）。 | 
| Histologically, histiocytes have a bland and fade-into-the background look to match their name (literally, “tissue cell”). They have pale-pink granular cytoplasm, sometimes with chunky phagocytosed bits of material, and indistinct cell borders (Figure 3.5). The nuclei are pale with crisp outlines, oval in shape, and often grooved. In tissue, a collection of histiocytes appears as an ill-defined pink area that is easy to miss. The nuclei often stream in a circular pattern like fish swimming in a barrel. Foamy macrophages are stuffed with lipid debris or organisms and can have an almost signet-ring appearance. | 组织学上，组织细胞温和，没有鲜明的呈现于背景中，以符合他们的名字（字面意思是“组织细胞”）。细胞质淡粉色、颗粒状，有时有大块被吞噬的物质，细胞边界模糊（图3.5）。细胞核淡染，轮廓清晰，呈椭圆形，常有凹槽。在组织中，组织细胞的聚集显示为一个不明确的粉红色区域，很容易被忽略。细胞核通常呈圆形流动，就像鱼在桶里游泳一样。泡沫样巨噬细胞充满脂质碎片或生物体，并且可以几乎呈印戒样形态。 | 
Figure 3.5. Histiocytes appear as pale folded nuclei within an area of inflammation; the cell borders are indistinct, but the nuclei are surrounded by light pink cytoplasm (circle). Compare the pale chromatin to that of the neighboring lymphocyte (arrowhead).
图3.5：在炎症区域内组织细胞核呈淡染皱褶状；细胞边界不清，但细胞核周围有淡粉色的细胞质（环形）。淡染的染色质和邻近淋巴细胞（箭头）的染色质进行比较。 | We usually refer to the presence of lymphocytes as chronic inflammation. Lymphocytes plus neutrophils equals acute and chronic inflammation. In the gastrointestinal tract, instead of acute we use active, such as active chronic gastritis or active chronic inflammatory bowel disease. Inactive disease in the gastrointestinal tract means increased lymphocytes and plasma cells but no neutrophils. Eosinophils, which are grouped under chronic inflammation, have a bilobed nucleus and big red granules. They are usually an indication of an immune/IgE response, such as allergy or parasites. | 我们通常把淋巴细胞的存在称为慢性炎症。淋巴细胞加上中性粒细胞等于急慢性炎症。在胃肠道中，我们用活动性代替急性，如活动性慢性胃炎或活动性慢性炎症性肠病。胃肠道的非活动性疾病意味着淋巴细胞和浆细胞增多，但没有中性粒细胞。嗜酸性粒细胞是慢性炎症的一类，具有双叶核和大红色颗粒。它们通常是免疫/IgE反应的迹象，如存在过敏或寄生虫感染。 |
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