Chronic inflammation 2 Flashcards
Describe granulomatous inflammation
Granulomatous inflammation is characterised by presence of granulomas (granulomata) in tissues and organs.
Granulomatous inflammation is stimulated by an indigestible antigen - in that the body is unable to rid itself of it.
Give illustrative examples of infective granulomatous inflammation
Tuberculosis - mycobacterium
Leprosy - Mycobacterium
Syphilis - Treponema
Give illustrative examples of non-infective granulomatous inflammation
Rheumatoid arthritis - tissue specific autoimmune disease
Sarcoidosis - classical clinical picture
Crohn’s disease - chronic inflammatory bowel disease
Describe wound healing.
This is a process of repair of tissue damage.
There is a (short) phase of acute inflammation.
Granulation tissue is then formed
There is then local angiogenesis.
Then , fibrosis and scar formation.
Describe fracture healing.
Modified by the situation in bone - dynamic tissue.
Have to repair the bony structure as well as the soft tissue
Define a ‘granuloma’
Granulomas are aggregates of epithelioid macrophages in tissue
These may contain giant cells
They may surround dead material
May be surrounded by lymphocytes.
They contain neutrophils, eosinophils
Respond to indigestible antigen.
Many are type IV hypersensitivity reactions.
Describe the formation of giant cells.
Giant cells are replications of macrophages:
Granulomas comprise epithelioid histiocytes (macrophages) and this results in fusion of macrophages to form larger cells.
Describe ‘Langhans type’ Giant cells
These are GIANT giant cells.
They are classically found in tuberculosis.
They have a peripheral rim of nuclei and have a large eosinophilic cytoplasm.
Describe ‘Foreign body type’ Giant cells
These are often associated with pyogenic granulation tissue:
- acutely inflamed
- Neutrophils, pus
- Organisation
- Giant cells
Describe ‘Touton type’ giant cells.
Often associates with Xanthomas and Xanthogranulomas.
They have a central cluster or ring of nuclei
Have a frothy cytoplasm.
Describe ‘silicone associated’ giant cells
(Ruptured silicone implants)
- Usually but not always breast
- Vacuoles contain leaked silicone
= Giant cell vacuole
Describe ‘Warthin-Finkeldy type’ Giant cells
These are seen, rarely, in measles.
There is a central cluster of nuclei
Describe the process of fracture wound healing
Trauma, fracture, haematoma (blood clot round fracture)
- Acute inflammation
- Organisation
- Granulation tissue
- Macrophages remove debris
The granulation tissue contains osteoblasts as well as fibroblasts - there is callus formation around the new bone.
The osteoblasts lay down woven bone - nodules of cartilage are present.
