Table 2-4 Examples of Granulomatous Inflammations
Discase Cause  Tissue Reaction
Bacterial    
Tuberculosis Mycobacterium tuberculosis Noncaseating tubercle (granuloma prototype) a focus of epithelioid cells, rimmed by fibroblast, lymphocytes, occasional Langhans' gant cell; caseating tubercle; central amorphous granular debris, loss of all cellular detail; acid-fast bacilli
Leprosy Mycobacterium leprae Acid-fast bacilli in macrophages; granulomas and epithelioid type
Syphilis Treponema pollidum Gumma; Microscopic to grossly visible lesion, enclosing wall of histiocytes; plasma cell infitrate; center cells are necrotic without loss of celluar outline
Cat-scratch disease Gram-negative bacillus Rounded of stellate granuloma containing central granular debris and recognizable neutrophils; giant cells uncommon
Parasitic    
Schistosomiasis Schistosoma mansoni, S.haematobium, S.japonicum Egg emboli; eosinophils
Fungal    
  Cryptococus neoformans Organism is yeast-like, sometimes budding; 5 to 10 mm; large, clear capsule
  Coccidioides immitis Organism appears as spherical (30-80 mm) cyst containing endospores of 30-80 mm each
Inorganic Metals and Dusts
Silicosis, berylliosis   Lung involvement; fibrosis
Unknown    
Sarcoidosis   Noncaseating granuloma; gian cells (Langhans and foreign-body types); asteroids in giant cells; occasional Schaumann's body (concentric calcific concretion); no organisms