Benign reactivity change



A benign reactive change means that the nature of the local lesion is benign, there is no tendency to malignant, and it is more common in the manifestation of inflammation.



Inflammation The response to local tissue damage to the body is called an inflammatory response.

First, according to the duration of the time is divided into acute and chronic. Acute inflammation is mainly caused by redness, swelling, pain, etc., that is, inflammation caused by the reaction of the vascular system. Local vasodilatation, slow blood, blood and neutrophils and other blood components exuded into the tissue, exudation is mainly centered on the vein, but the exudation of high molecular substances such as protein only uses pressure difference and colloidal penetration inside and outside the blood vessel. The pressure difference of the pressure cannot be explained, and the role of various substances capable of enhancing vascular permeability is emphasized. This substance mainly has:

(1) Amines, serotonin and other amines can cause immediate reactions after inflammatory stimuli.

(2) A polypeptide represented by bradykinin, kallidin, and methio-nyl-lysyl-bradykinin. Its common features are vascular hyperpermeability, smooth muscle contraction, vasodilation, and promotion of leukocyte migration. The structure of the bradykinin and lysyl bradykinin has been determined.

(3) Proteases such as plasmin, kallikrein, and globulin-PF are not themselves acting as vascular permeability substances. However, kininine can be made to become a kinin. However, it is unknown that the above substances act on the part of the blood vessel and the mechanism of action. Histologically, it can be seen that the vascular exudation reaction and the repair process are mixed together when acute inflammation occurs. It can be seen that macrophages, lymphocytes, plasma cells infiltrate and fibroblast proliferation.

Second, the main organizational changes from inflammation can be classified as follows:

(1) Metamorphic inflammation.

(2) Exudative inflammation (serous inflammation, fibrinitis, suppurative inflammation, hemorrhagic inflammation, necrotizing inflammation, catarrhal inflammation).

(3) proliferative inflammation.

(4) Specific inflammation (tuberculosis, syphilis, leprosy, lymphogranuloma, etc.) inflammation-cause; physical factors; chemical factors; biological factors; necrotic tissue; allergic reaction and abnormal immune response; inflammation-local basic pathology Variety.

1, deterioration

Alteration: Degeneration and necrosis of local tissue in inflammation.

2, seepage

Exudation: The process by which fluid and cellular components of blood vessels enter the extravascular tissue through the vessel wall during inflammation. Exudation is the most characteristic change of inflammation and the central link of inflammation.


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As early as the first century AD, the Roman writer Cornelius celsus had proposed that the inflammation mainly manifested in four major symptoms: ruber, tumor, calor and clolor. It was not until the 19th century that the famous German pathologist Virchow listed local dysfunction as the fifth symptom of inflammation. Red and heat are caused by local vasodilation of the inflammation and accelerated blood flow.

The swelling is caused by local inflammatory hyperemia and exudation of blood components. Pain is caused by exudate compression and certain inflammatory mediators acting directly on the nerve endings. The location, nature and severity of inflammation will also cause different dysfunctions.

Systemic reactions caused by inflammation often include increased fever and peripheral white blood cell counts. Fever is associated with infectious inflammation, especially when the pathogen spreads into the blood. In the inflammation caused by bacterial infection, the peripheral white blood cell count can reach 15000 ~ 20000 / mm3, or even higher, and the proportion of relatively immature rod-shaped neutrophils increases, which is the so-called "nuclear left shift" ". Certain infections, such as viral diseases and typhoid fever, can also result in a decrease in peripheral white blood cell counts.


Differential diagnosis

Differential diagnosis of benign reactivity changes:

1. Inflammation of the whole body: the inflammatory response syndrome (SIRS): is a self-sustaining self-sustaining and self-destructive systemic inflammatory response caused by an uninfected or non-infectious cause of the body. It is a clinical process in which the body undergoes excessive stress response during repair and survival. When the body is attacked by exogenous damage or toxic substances, it can promote the initial inflammatory reaction, and at the same time, the endogenous immune inflammatory factors produced by the body form a "waterfall effect." Critically ill patients are most likely to trigger SIRS due to reduced compensatory anti-inflammatory response and metabolic dysfunction. Severe cases can lead to multiple organ dysfunction syndrome (MODS).

2, micro-inflammatory state: due to the involvement of inflammatory substances in the intravascular inflammation called: micro-inflammatory state. Dialysis patients do not have signs of systemic or localized clinical signs of infection, but have a low, sustained state of inflammation characterized by elevated inflammatory factors.

3, multiple neuritis: a variety of causes can affect the peripheral nerves such as simultaneous peripheral nerve damage, called polyneuritis. Mainly manifested as changes in the symmetry of the distal limbs, activity, skin color, sweating and other changes. Both men and women of any age can develop symptoms.

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