Granulomatous disease: Difference between revisions

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(Created page with "== Background == * Granulomatous inflammation is chronic inflammation that involves macrophages and T lymphocytes to wall off an infectious organism * T cells are activated and in turn activate macrophages, which undergo morphological changes to become more epithelioid * Creates two main types of granulomas: foreign body granulomas, and immune ganulomas ** In immune granulomas, macrophages active T cells to produce IL-2 == Differential Diagnosis == * Tuberculosis...")
 
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== Differential Diagnosis ==
== Differential Diagnosis ==


* Infections
* [[Tuberculosis]]: caseating granulomas, with acid-fast bacilli
* Mycobacteria
* [[Leprosy]]: non-caseating granulomas, with acid-fast bacilli in macrophages
** '''[[Tuberculosis]]''': caseating granulomas, with acid-fast bacilli
* [[Syphilis]]: gummas, which contain a wall of histiocytes, plasma cell infiltrate, and necrotic central cells without loos of cellular outline
** '''[[Leprosy]]:''' non-caseating granulomas, with acid-fast bacilli in macrophages
* [[Cat scratch disease]]: rounded or stellate granulomas with central granular debris and neutrophils; giant cells are uncommon
** [[Non-tuberculous mycobacteria]]
* [[Sarcoidosis]]: non-caseating granulomas with abundant activated macrophages
** [[Buruli ulcer]] ([[Mycobacterium ulcerans]])
* [[Crohn disease]]: occasional non-caseating granulomas in intestinal wall
** BCG vaccination
* Fungi: [[histoplasmosis]], [[coccidiomycosis]], [[blastomycosis]], [[sporotrichosis]], aspergillosis
* , [[cryptococcosis]]
* Protozoa: [[toxoplasmosis]], [[schistosomiasis]]
* Spirochetes
** '''[[Syphilis]]''': gummas, which contain a wall of histiocytes, plasma cell infiltrate, and necrotic central cells without loos of cellular outline
** [[Treponema carateum]]
** [[Treponema pertenue]]
* Bacteria
** '''[[Cat scratch disease]]''': rounded or stellate granulomas with central granular debris and neutrophils; giant cells are uncommon
** [[Brucella]], [[Yersinia]], [[Whipple diseaes]]
* Vasculitis: [[GPA]], [[EGPA]], [[lymphomatoid vasculitis]], [[polyarteritis nodosa]], [[bronchocentric vasculitis]], [[giant cell arteritis]], [[systemic lupus erythematosus]]
* Other inflammatory disorders:
** '''[[Sarcoidosis]]''': non-caseating granulomas with abundant activated macrophages
** [[Crohn disease|'''Crohn disease''']]: occasional non-caseating granulomas in intestinal wall
** [[Primary biliary cirrhosis]], [[hepatic granulomatous disease]], [[Langerhan granulomatosis]], [[Peyronie disease]], [[Blau syndrome]], [[hypogammaglobulinemia]], [[Langerhan cell histiocytosis]], [[immune complex disease]]
* Leukocyte oxidase defects: [[chronic granulomatous disease]]
* [[Hypersensitivity pneumonitis]]: farmer's lung, bird fancier's lung, mushroom worker's lung, suberosis (cork dust), bagassosis, maple bark stripper's lung, paprika splitter's lung, coffee bean lung, Spatlese lung
* Chemical exposures: beryllium, zirconium, silica, starch, talc
* Neoplasms: carcinoma, reticulosis, pinealoma, dysgerminoma, seinoma, reticulum cell sarcoma, malignant nasal granuloma
* Miscellaneous: [[lymphogranuloma]], [[Kikuchi syndrome]]

== Further Reading ==

* James DG. A clinicopathological classification of granulomatous disorders. ''Postgrad Medical J''. 2000;76:457-465. doi: [https://doi.org/10.1136/pmj.76.898.457 10.1136/pmj.76.898.457]

Revision as of 15:10, 2 November 2022

Background

  • Granulomatous inflammation is chronic inflammation that involves macrophages and T lymphocytes to wall off an infectious organism
  • T cells are activated and in turn activate macrophages, which undergo morphological changes to become more epithelioid
  • Creates two main types of granulomas: foreign body granulomas, and immune ganulomas
    • In immune granulomas, macrophages active T cells to produce IL-2

Differential Diagnosis

Further Reading

  • James DG. A clinicopathological classification of granulomatous disorders. Postgrad Medical J. 2000;76:457-465. doi: 10.1136/pmj.76.898.457