Chronic Inflammation

Question 1

Characteristics of chronic inflammation

Answer 1

Infilteration with mononuclear cells, including macrophages (monocytes), lymphocytee and plasma cells /// esinophils /// mast cells.
Tissue distruction, repair and angiogenesis and fibrosis

Question 2

Causes of chronic inflammation:

Answer 2

Persistant infections
Immune mediated inflammatory and autoimmune disease
Prolonged exposure to potentially toxic agents

Question 3

Types of chronic inflammation

Answer 3

Non specific (when there is no histological clue).
Specific chronic inflammation e.g (granulomatous inflammation with necrosis, is a clue of Tuberculosis)

Question 4

Granulomatous inflammation with necrosis is a clue of :

Answer 4

Tuberculosis

Question 5

What is the granulomatous inflammation?

Answer 5

It is a distinctive pattern of chronic inflammation characterised by granuloma formation

Question 6

What is the Granuloma?

Answer 6

It is a focal collection of modified macrophages called epitheloid cells along with multinucleated giant cells and surrounding lymphocytes and fibrosis

Question 7

when granuloma occurs?

Answer 7

It occurs in the presence of indigestible material or cell-mediated immunity (“type IV hypersensitivity”)

Question 8

E.g of granulomatous infla ..:

Answer 8

Tuberculosis(mycobacterium tu..)
Leprosy (Mycobacterium leprae)
Syphils (Treponema pallidum)
Cat scratch disease (gram- bacilli)
Schistosomiasis(parasite)
Cryptococcus neoformans and coccidoies immits(fungal)

Question 9

Other e.g of granulomatous infla…:

Answer 9

Berylliosis
Sarcoidosis
Crohn’s disease

Question 10

Origing of granulomas:

Answer 10

Immune granulomas ( mediated by T Cell)
Foreign body granuloma

Question 11

Types of granulomas:

Answer 11

Hard granuloma (no necrosis) 
Soft granumola ( central caseous necrosis)
Gumma (rubbery)

Question 12

Sarcoidosis is e.g of :

Answer 12

Hard granuloma

Question 13

TB and histoplasmosis are e.g of:

Answer 13

Soft granuloma (central caseous necrosis)

Question 14

Syphilis is e.g of:

Answer 14

Gumma (rubbery) granuloma

Question 15

LM appearance of Granuloma:

Answer 15

Collection of modified macrophages called epitheloid
Collar of lymphoid surround epitheloid
Scattered giant cells
Old granulomqe may have surrounding fibrosis
Caseous necrosis is seen in the centre of granuloma in TB

Question 16

Types of giant cells in granuloma:

Answer 16

Langerhan’s : nuclei distributed in the periphery like a horse shoe
Foreign body giant cells : nuclei is distributed in scattered fashion

Question 17

Other types of giant cells in pathology:

Answer 17

Oseoclastic giant cells, Touton giant cells in xanthoma

Question 18

Mechanism of granuloma formation:

Answer 18

Formation of memory cells from CD4+ T lymphocytes a/f first exposure to causative agent.
2nd exposure to agent 》memory cells become activated》blastic transformation》cytokines secretion(IL-2,INF-GAMMA,TNF)》granuloma formation.