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Granuloma in Lung (20X)
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Granuloma in Lung (20X)

This is a close up view of one portion of a granuloma.
The center of the image is a multinucleated giant cell.
To the left is relatively acellular collagen.
To the right are numerous lymphocytes forming the external collar of the lesion.
(Description By:T.V. Rajan, M.D. )
(Image Contrib. by:T.V. Rajan, M.D. UCHC )
Granuloma N.O.S.
Etiology

Various of organisms including Mycobacteria, Histoplasma, and Coccidioides
Hypersensitivity to allergens
Sarcoidosis
Wegener's granulomatosis orChurg-Strauss granulomatosis
Foreign material
Rheumatoid arthritis
Lymphomatoid granulomatosis
Unknown
Pathogenesis

If acute inflammatory response fails to deal with antigen then granuloma may form secondary to cell-mediated response
Generally follows if antigen cannot be readily destroyed,
Epidemiology

That of the underlying disease process
General Gross Description

Round firm nodules which may have soft center if necrotizing
General Microscopic Description

Aggregate of macrophages accompanied by multinucleated macrophages with identical nuclei
Center may be necrotic
Macrophages may contain recognizable foreign material or organisms
Lymphocytes ring the aggregate
Clinical Correlation

Granulomas may eventually be completely replaced by dense collagenous connective tissue
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th edition. Philadelphia, W.B. Saunders, 1994, pp. 324-327 and 712-714.
Granuloma N.O.S.
Synopsis by: Melinda Sanders M.D. (T28000M44000)[435]
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