Granulomatous and specific inflammations Flashcards
what is granulomatous inflammation
- most common type of specific inflamamiton
- chronic inflammation
-exsudation- monocytes, macrophages, hsitoocytes - prolif–>specific granulation tissue
-varibale alteration–>necrosis
granuloma
localized(tumoriform) inflammatory infiltarte with vharcateristic (organoid) internal arrangment
cellualr components of granulomas
macrophages
hsitocyties–<epitheloid or epitheloid histiocyets
giant cells
lymphocytes, plasma cells
NO VESSLES-avascular
Fibroblasts–>fibrotization in healing
diff btw non specific and specifinc
non-specific:
- prolif of new vv –>prolif of endothelial cells +fibroblasts–>collagen
- some inflamamotey cells of macrophages or lymphocyes
- end with fibrotic scar
specific:
- usually arranged, forming lesions called granulomas
- composed of monocytic, histiocytic origin-epotheloid histiocytes
- some other lymohocytes
- Avascular
roel of granulomatous inflammaiton
- relatively inert (poorly degradebale) material (exo/endo, biogen/abiogen origin)
- chronnic and persistent infection, highly virulent and poorly degradable microorganisms or antigens–>to surrond and stop spreading, prepare agent for destruction
- autoimmnuen and allergic (hypersensitive )process
- 4TH TYPES: cell emdiated/delayed - inadequate healing of acute inflamamiton
- some immunologcical disorders (immunodeficienct syndromes)
infectinous disorder: TB
mycobacterium tb (and bovis)
infectinous disorder: leprosy
mycobacterium leprae
infectinous disorder:syphilis(3rd stage)
treponema pallidum
caseuous necrosis
infectinous disorder: cat scratch disease (CSD)
bartonella henselae
- regional nodes are developing absessing granulomas
infectinous disorder: mesenterial lymphadentitis
Yersenia pseudotuberculosis, Y.enerocolitica
inflammation of intraabdomnial lymph node
infectinous disorder: lymphogranuloma venerum
chlamydia trachomatis
- sexually transmitted
- abseccing inflammaiton in inguinal pelvic ln
infectinous disorder: rhinoscleroma
klebilla rhinosceromatis
-specific inflammaiton of nasal mucosa
infectinous disorder: tularemia and listerosis
francisella tularensis and listeria monocytogenes
- animals to humans
mycotic infections
histoplasmosis, cryptococcosis, coccidimycosis, blastomycosis
parasitic infections
may lead to specific granulomatous morphologhy
non infecitons disorders: autoimmune disroders
- sarcoidosis
- rheumatic fever: aschoff nodules
- after streptococcal in ,ymphoepithelial tissue in throat
- heart–>tehse nodules - rheumatic arthriti
- rheumatoid granulomas - extrinsic allergic alveolitis (hypersensitive pneumonitis)
- chrons disease
forign body reaction
- ## most common
foreign body granulomas-
macrophage type of granuloma or giant cell rwaction
- granuloma with low cell tunrover
- giant cells
-respon of non-sepcific immune system
non-necrotizing epitheloid granuloma
-sacoidosis type
- composed of epitheloid histiocytes
-not developing necrosis
- autoimmune
- involving lung and mediastinal lymphnodes
- epitheloid histiocyes, hiant multinucleated cells and intra cytoplasmatic inclusions represented by Asteroid bodies and schaumanns bodies
necrotizing epitheloid granuloma
-tuberculosis type-caseous
- composed of epitheloid histiocytes
-undergo central causeous necrosis
-
abscessing granuloma
-pseudotuberculosos type-purulent colliquaition
- very infiltarted by neutrophils
- CSD,
lymphogranuloma venerum, mesenterial lymphadentitis
rheumatic and rheumatoid granulomas
-fibrinoid necrosis
- autoimmune and immunopathological process
- rheumatic fever and rheumatoid arthirtis
- achoff and antischkow cells
- mixed some lymphocytes and eosinophils
TB -primary
-childhood tupe
-first type infeciton, no vaccination
-primary ghon complec=primary focus+regional lymphangitis and lymphadenitis (granuloma+central necrosis=ghon complex)
- LUNG(lower and middle lobes) AND LESION
- formation of granuloma(clusters of immune cells like macro or t-cells to contain bacteria)
–>latent TB
- asymptomatic
post primary/secondary TB
-reactivation of primary
- in vaccinated patient(BCG vaccination=imitate primoinfeciton)
- upper lobes of lungs
developemnt of tuberculoss
- resp system
- aerobic bacteria–therfore in lungs
mycobacteria survive in alveolar macrophages–>spread thorugh lymphatic vv–>send signals –>act of CD4+ t cells–>act and acc of other macrophges–>prlifatis around infected cells –>barrier–>stop spreafing
when hypersensitive reaction in tcells–>cytotoxic t cell kill infected cells toegether with these baceeria
microscopical apperance of tuberculous granuloma
- epitheloid histocytes
- radially arranged to cneter like sun
- these histiocytes fusing toegther–>giant multinucleated cells
- Langshans cells
-in periphery: mixed lymphocytes-mostly t lymphocytes
- Langshans cells
forms of tuberculous inflammaiton
- proliferative form=granulomas-signs of resitance=KOCHS phenomen
- large granulomas
-small (miliary) nodules (tubercules) - exsudative form=serofibrinoys inflammaiton, ORTH CELLS-signs of allergy
- necrotization
syphilis
- cnetral necrosis
- 3rd stage
- composed of lymphocytes, multiple plasma cells, histiocytes, multinucleated giant cells, central caseous necrosis
gummas
actinomycosis
- actinomycotic colonies -SUPLHUR GRANULES, sorrunded by firbrinous material, neurtrophils, histiocytes, giant multinucleated cells
leprosy
Forms:
1. tuberculoid
- prliferative type
- composed of epitheloid histiocytes, giant multinucleated cells
- lead to destruction of peripheral nerves–>loss of peripheral sensitivity
-lesions
- lepramatous (humid type)
- exsudative type
-not typical granulomas
- foamy macrophages
rhinoscleroma
-nasal cavity and nose
-lymphocytes, plasma cells, ginat polygonal cells with morphology of foamy=MIKULICZ cells
