Granulomatous Inflammation

Question 1

Describe granulomatous inflammation

Answer 1

A distinct pattern of chronic inflammation characterised by activated macrophages.

Question 2

What is a granuloma?

Answer 2

A focal collection of inflammatory cells at sites of tissue infection. Macrophages are transformed into epithelium-like cels, surrounded by a collar of mononuclear leukocytes, principally lymphocytes and occasionally plasma cells.

Question 3

What are the two main types of granuloma

Answer 3

1. Immune granuloma
2. Foreign body granuloma

Question 4

Multi-system condition common in females prior to age 50, and black population. Can cause oral lesions in the submucosa in the form of papules, areas of granularity, ulcers.

Approximately 90% of patients affected will reveal and abnormal chest x-ray.

Answer 4

Sarcoidosis

Question 5

Tests for diagnosis of Sarcoidosis:

Answer 5

• Clinical appearance
• Chest x-ray
• sACE levels (elevated)

Question 6

Inflammatory and probably immunologically meiated condition affecting the distal bowel and proximal colon

Answer 6

Crohns Disease

Question 7

Oral lesion appearance Crohns Disease:

Answer 7

• Diffuse or nodular swelling
• Cobblestone appearance
• Linear ulcer at buccal vestibule
• Swelling, mucosal tags
• Apthous like ulcer

Question 8

3 granulomatous diseases which can cause oral lesions

Answer 8

• Sarcoidosis
• Crohns Disease
• Orofacial Granulomatosus