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Chronic Inflammation: LOM, Granulomatous, Add histology of cells on Anki,…
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Granulomatous
How is a granuloma formed ? A granuloma results when substances provoking inflammation cannot be digested by neutrophils and are ingested by macrophages to prevent perpetual stimulation of acute inflammation and tissue destruction. Macrophages are suitable for the job as they are much longer-lived that neutrophils.If they are not killed by noxious agent, they sequester it in the cytoplasm , lose motility, accumulate and become epithelioid in appearance. What is a Granuloma ?A granuloma is composed of nodular collections of epithelioid macrophages and are usually surrounded by lymphocytes and fibroblasts. Multinucleated inflammatory giant cells and/or necrosis are frequently but not always present. What is the most common cause of Granulomatous Infection ?
- Foreign Bodies
exogenous: Sutures
endogenous: Keratin
- Some Bacteria
Tuberculosis: Caseous Necrosis
Syphilis: Coagulative Necrosis
- Fungi
Histoplasmosis: Collections of Neutrophils
- Parasites
Schistosomiasis: Eosinophils
- Idiopathic
Sarcoidosis: Inclusions in giant cells
NOTE: Histological features provide clue to underlying aetiology.
Multinucleated Giant Cells How are Multinucleated Giant Cells Formed ?Multinucleated giant cells are created by the fusion of several macrophages in certain characteristic chronic inflammatory conditions, usually in the vicinity of exogenous or endogenous poorly digestible material.What causes MGC ?
- Infections: TB in which the nuclei are arranged in a U-shape (Langhans cells)
- Foreign body reactions in which the nuclei are dispersed through the cytoplasm.
- Phagocytosis of Lipid
- Collagen disease
- Idiopathic: Sarcoidosis, Crohn's disease
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