Granulomatous disease
From IDWiki
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: caseating granulomas, with acid-fast bacilli
- Leprosy: non-caseating granulomas, with acid-fast bacilli in macrophages
- Syphilis: gummas, which contain a wall of histiocytes, plasma cell infiltrate, and necrotic central cells without loos of cellular outline
- Cat scratch disease: rounded or stellate granulomas with central granular debris and neutrophils; giant cells are uncommon
- Sarcoidosis: non-caseating granulomas with abundant activated macrophages
- Crohn disease: occasional non-caseating granulomas in intestinal wall
