A histopathological study of granulomatous lesions

Background: Granulomas are the commonest lesions that the pathologists come across in routine practice. Granulomatous inflammation is a special type of chronic inflammation that is a manifestation of many infective, toxic, allergic, autoimmune and neoplastic diseases and also conditions of unknown etiology. The aim of this study is to analyze different granulomatous lesions and to find the frequency and etiology of all granulomatous lesions.Materials and Methods: The study included a total of 218 granulomatous lesions, received over a period of one year from July 2013 to June 2014 in the department of pathology, TUTH. Special stains like Ziehl-Neelsen, PAS and Wade- Fite- Faraco were done whenever required.Results: Granulomatous lesion accounted for 3% of all biopsies. The median age of the patients was 29 years and the majority of the patients were in the age group of 20-29 years with no sex predilection. Majority of granulomas were seen in lymph nodes (32.1%), followed by skin and subcutis (29.4%), and bones and joints (11%). Tuberculosis was the most common cause of granuloma with 143 (65.6%) cases, followed by leprosy, foreign body and fungal infection. The most common type of granuloma was epithelioid (87.2%), followed by epithelioid with suppuration, histiocytic, foreign body and mixed inflammatory.Conclusion: The granulomatous lesion is common in third decade of life with no sex predominance. The commonest site is lymph node with tuberculosis being the most common cause followed by leprosy. The epithelioid type was the most common type of granuloma.

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Granulomatous inflammation: A histopathological study

Journal of Pathology of Nepal ◽

10.3126/jpn.v3i6.8994 ◽

2013 ◽

Vol 3 (6) ◽

pp. 464-468 ◽

Cited By ~ 3

Author(s):

RC Adhikari ◽

KB Shrestha ◽

G Sayami

Keyword(s):

Lymph Nodes ◽

Fungal Infections ◽

Granulomatous Inflammation ◽

Common Type ◽

University Teaching ◽

Unknown Etiology ◽

Histopathological Study ◽

Granulomatous Lesion ◽

Common Cause ◽

Male Predominance

Background: Granulomatous inflammation is a special type of chronic inflammation that is being a manifestation of many infective, toxic, allergic, autoimmune and neoplastic diseases and also conditions of unknown etiology. Materials and Methods: The study included a total of 418 granulomatous lesions, diagnosed from January 2010 to December 2012 in the department of pathology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Results: The median age of the patients with granulomatous lesion was 29 years and the majority of the patients were in the age group of 20-29 yrs with slight male predominance. Majority of granulomas were seen in lymph nodes (41.1%), followed by skin & subcutis (22%), and bone & joints (11.5%). Tuberculosis was the most common cause of granuloma with 258 (61.7%) cases, followed by fungal infections, foreign body reaction, parasites and toxoplasmosis. Out of 258 cases of tuberculosis, lymph nodes were involved in 140 (54.26%) cases, followed by bone & joints (12.79%) and respiratory system (5.42%). The most common type of granuloma was epithelioid (83.5%), followed by epithelioid with suppuration and mixed inflammatory. Conclusion: The granulomatous lesion is common in third decade of life with slight male predominance. The commonest site is lymph node with tuberculosis being the most common cause and epithelioid being the most common type of granuloma. DOI: http://dx.doi.org/10.3126/jpn.v3i6.8994 Journal of Pathology of Nepal (2013) Vol. 3, 464-468

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Pityriasis rosea: a clinicoepidemiological study of 115 cases

International Journal of Research in Dermatology ◽

10.18203/issn.2455-4529.intjresdermatol20181398 ◽

2018 ◽

Vol 4 (2) ◽

pp. 202

Author(s):

Srirath Madappally Kambil

Keyword(s):

Seasonal Variation ◽

Common Type ◽

Unknown Etiology ◽

Atypical Presentation ◽

Age Group ◽

Human Herpes ◽

Pityriasis Rosea ◽

Human Herpes Virus ◽

The Common ◽

One Year

Background: Pityriasis rosea (PR) is a skin eruption of unknown etiology, probably related to human herpes virus-7 (HHV-7).Methods: One hundred and fifteen patients with PR who presented to the dermatology outpatient department over a period of one year from May 2016 to April 2017 were included in the study. The various clinicoepidemiological features observed in these patients are recorded in the study.Results: Majority of patients (55%) belonged to the age group of 11 to 30 years with the youngest patient being 16 months of age. Mild seasonal variation was observed with maximum cases occurring during September and October. Classical PR was the common type seen and papular PR was the most common atypical presentation. Majority of the cases (78%) lasted for 4 to 5 weeks.Conclusions: PR is a common self-limiting disorder seen in young adults. Knowledge about the disease will help in correct management and prevent unnecessary distress to the patient.

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Abdominal Tuberculosis: A Histopathological Study with Special Reference to Intestinal Perforation and Mesenteric Vasculopathy

Journal of Laboratory Physicians ◽

10.4103/0974-2727.59700 ◽

2009 ◽

Vol 1 (02) ◽

pp. 056-061 ◽

Cited By ~ 16

Author(s):

Alakananda Dasgupta ◽

Navjeevan Singh ◽

Arati Bhatia

Keyword(s):

Histopathological Examination ◽

Intestinal Tuberculosis ◽

Granulomatous Inflammation ◽

Abdominal Tuberculosis ◽

Epithelioid Cell ◽

Histopathological Study ◽

Ulcer Formation ◽

Microscopic Features ◽

History Of ◽

One Year

ABSTRACT Background: Along with the increased incidence of pulmonary tuberculosis in parallel with the increase in population in various parts of the world, in recent years, the incidence of abdominal tuberculosis has also increased. The pathogenetic events in intestinal tuberculosis, which culminate in ulcer formation, perforation, and stricture, still have to be identified. Aim: To correlate the gross and microscopic features in intestinal tuberculosis, in particular tuberculous perforation with changes in mesenteric vasculature. Patients and Methods: A one-year prospective study of excised/resected tissues from patients with abdominal tuberculosis requiring surgical intervention was conducted. Tissues from fifty-six patients were included in the study — of which 36 were resected intestinal segments and 20 were intestinal and lymph node biopsies. Hematoxylin and Eosin and Ziehl-Neelsen stains were used for histopathological examination. Results: Tuberculous enteritis was found to be present in 49 of the 56 patients (87.5%) (ileum being the site most commonly affected), while nodal involvement was seen in 39 (69.6%) patients. Perforations were present in 39 out of 49 (79.6%) intestinal tissues; most being solitary and ileum was the commonest site. Typical epithelioid cell granulomas were seen in the intestine and lymph nodes, with caseation being more prevalent in the latter. The mesenteric vasculature was frequently involved by granulomatous inflammation, with intravascular organizing thrombus being present in 30% of the resected specimens with perforation. Acid fast bacilli were demonstrated in the tissue sections of 37.5% of the patients. AFB positivity was higher in caseating granulomas. Conclusion: Involvement of mesenteric vasculature by granulomatous inflammation was commonly associated with the ulcerative type with perforation, suggesting that ischemia caused by vascular thrombosis is responsible for tissue breakdown. This implies that vasculitis plays an important role in the natural history of abdominal tuberculosis.

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Trehalose 6,6′-Dimycolate (Cord Factor) ofMycobacterium tuberculosis Induces Foreign-Body- and Hypersensitivity-Type Granulomas in Mice

Infection and Immunity ◽

10.1128/iai.69.2.810-815.2001 ◽

2001 ◽

Vol 69 (2) ◽

pp. 810-815 ◽

Cited By ~ 69

Author(s):

Hirokazu Yamagami ◽

Takayuki Matsumoto ◽

Nagatoshi Fujiwara ◽

Tetsuo Arakawa ◽

Kenji Kaneda ◽

...

Keyword(s):

Foreign Body ◽

Granulomatous Inflammation ◽

Mycobacterial Infection ◽

Host Responses ◽

Body Type ◽

Active Lesion ◽

Immunoregulatory Cytokines ◽

Granulomatous Lesions ◽

Cord Factor ◽

First Time

ABSTRACT Granulomatous inflammation is characterized morphologically by a compact organized collection of macrophages and their derivatives. It is classified as either a hypersensitivity type or a foreign-body type. Lipid components of the Mycobacterium tuberculosis cell wall participate in the pathogenesis of infection. Strains of M. tuberculosis have cord factor (trehalose 6,6′-dimycolate [TDM]) on their surface. To clarify host responses to TDM, including immunogenicity and pathogenicity, we have analyzed the footpad reaction, histopathology, and cytokine profiles of experimental granulomatous lesions in immunized and unimmunized mice challenged with TDM. In the present study, we have demonstrated for the first time that TDM can induce both foreign-body-type (nonimmune) and hypersensitivity-type (immune) granulomas by acting as a nonspecific irritant and T-cell-dependent antigen. Immunized mice challenged with TDM developed more severe lesions than unimmunized mice. At the active lesion, we found monocyte chemotactic, proinflammatory, and immunoregulatory cytokines. The level was enhanced in immunized mice challenged with TDM. This result implies that both nonimmune and immune mechanisms participate in granulomatous inflammation induced by mycobacterial infection. Taken together with a previous report, this study shows that TDM is a pleiotropic molecule against the host and plays an important role in the pathogenesis of tuberculosis.

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A Histopathological Study of Granulomatous Inflammation

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1703548 ◽

2012 ◽

Vol 02 (01) ◽

pp. 15-19 ◽

Cited By ~ 1

Author(s):

Harish S. Permi ◽

Jayaprakash Shetty K. ◽

Shetty K. Padma ◽

Teerthanath S. ◽

Michelle Mathias ◽

...

Keyword(s):

Fungal Infections ◽

Histopathological Examination ◽

Subcutaneous Tissue ◽

Specific Treatment ◽

Granulomatous Inflammation ◽

Histopathological Study ◽

Serological Tests ◽

Medical Academy ◽

Granulomatous Lesions ◽

Exact Etiology

AbstractGranulomatous inflammation is a distinctive pattern of chronic inflammation that is encountered in a limited number of infectious and non-infectious conditions. Recognisation of granulomatous pattern and finding the etiology in a biopsy specimen is very important for specific treatment and outcome of the disease. We aimed at finding the etiology of all granulomatous lesions on tissue biopsy sent for histopathogical examination. A study was done at K S Hegde Medical Academy of Nitte University, Mangalore from January 2009 to December 2010. All the cases which were diagnosed as granulomas on Hematoxylin and Eosin stained sections were selected. Special stains like Ziehl-Neelsen stain, Gomori's Methenamine silver, PAS, Fite Faraco were done whenever required. We encountered 275 granulomatous lesions in our study. The most common sites were skin and subcutaneous tissue, lymph nodes, bones and joints. The commonest cause of granulomas was tuberculosis, followed by leprosy, foreign body granulomas, fungal infections, rhinoscleroma, parasites, tumor granulomas and actinomycosis. The morphological features and special staining helped us to find the specific etiology of granulomas in 253 cases whereas it could not be determined in 22 cases even after special stains. Thus we conclude that histopathological examination of granulomatous lesions helped us to find the exact etiology of granulomas in 92 % of cases. The correlation of histopathology with polymerase chain reaction (PCR) serological tests and culture correlation would have helped to find the specific etiology in the remainder of cases.

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Sarcoidosis of the breast: an unusual clinical presentation

Revista de Ciências Médicas e Biológicas ◽

10.9771/cmbio.v17i3.23493 ◽

2018 ◽

Vol 17 (3) ◽

pp. 403

Author(s):

Jozélio Freire Carvalho ◽

Cleófano Lima Ramos ◽

Paulus Mascarenhas Ramos ◽

Virginia Freitas de Sá Oliveira ◽

Danilo Barral de Araujo

Keyword(s):

Clinical Presentation ◽

Erythema Nodosum ◽

Pulmonary Nodules ◽

Serum Levels ◽

Unknown Etiology ◽

Histopathological Study ◽

Granulomatous Disease ◽

Mediastinal Lymph Nodes ◽

Granulomatous Lesions ◽

History Of

<pre>Introduction: Sarcoidosis is a chronic systemic granulomatous disease of unknown etiology. The breast may be involved in less than 1% of cases and often mimics carcinomas at clinical examination. Case report: Herein, the authors report a 54-year-old woman who had history of erythema nodosum, had clinical presentation suggestive of mastalgia whose mammography and ultrasound showed bilateral unspecific heterogeneous parenchymal densities. Histopathological study revealed non-caseous giant cell granulomas. Specifically, serum levels of angiotensin-converting enzyme (ACE) were elevated and a CT scan showed small bilateral pulmonary nodules distributed along the pleura and bronchovascular bundles (perilymphatic pattern), however without enlarged bilateral hilar and mediastinal lymph nodes. The patient was treated with prednisolone and methotrexate, and is currently asymptomatic. Conclusion: Breast involvement by sarcoidosis, although rare, should be considered when dealing with granulomatous lesions of the breast.</pre>

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Evaluation of Breast Lumps by Ultrasound and Correlation with Histological Findings

Journal of Surgical Sciences ◽

10.3329/jss.v23i1.44238 ◽

2020 ◽

Vol 23 (1) ◽

pp. 10-12

Author(s):

Nelema Jahan ◽

Md. Mamunur Rahman ◽

Mohammad Shahidul Alam ◽

Md Saiful Islam

Keyword(s):

Histopathological Examination ◽

Breast Diseases ◽

Histopathological Study ◽

Common Symptom ◽

Breast Lump ◽

Histopathological Findings ◽

Malignant Breast ◽

Breast Lumps ◽

One Year ◽

A Prospective Study

Background: A breast lump is the most common symptom associated with both benign and malignant breast diseases. Therefore, a distinction of benign from malignant lump is of importance for proper management. Though a definitive diagnosis is possible with imaging for all the lesions, histopathological study is proven essential for confirming the diagnosis. Objective: The objective of this study was to evaluate the role of USG and histopathological findings of different breast lump in diagnosis and their comparison. Methods: A prospective study was conducted over a period of one year from January 2017 to December 2017. A total of 116 patients were included in this study. All breast lumps underwent surgery and the ultrasound findings of these lumps were compared with the histopathological findings. Data were collected from these patients by a preformed questionnaire and finally the data were analyzed. Results: Out of 116 patients only 21 cases were reported as malignant in ultrasound report but histopathology revealed 31 malignant patients. On histopathological examination 10 benign cases turned out to be malignant. Conclusion: The present study was undertaken to evaluate in diagnosing breast mass lesions individually by ultrasound and compared with histopathology for definitive management of a patient. Journal of Surgical Sciences (2019) Vol. 23 (1) : 10-12

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Disrupting the LINC complex by AAV mediated gene transduction prevents progression of Lamin induced cardiomyopathy

Nature Communications ◽

10.1038/s41467-021-24849-4 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Ruth Jinfen Chai ◽

Hendrikje Werner ◽

Peter Yiqing Li ◽

Yin Loon Lee ◽

Khaing Thet Nyein ◽

...

Keyword(s):

Cardiac Failure ◽

Viral Vector ◽

Nuclear Periphery ◽

Dominant Negative ◽

Gene Transduction ◽

Linc Complex ◽

Specific Expression ◽

Common Cause ◽

Complex Protein ◽

One Year

AbstractMutations in the LaminA gene are a common cause of monogenic dilated cardiomyopathy. Here we show that mice with a cardiomyocyte-specific Lmna deletion develop cardiac failure and die within 3–4 weeks after inducing the mutation. When the same Lmna mutations are induced in mice genetically deficient in the LINC complex protein SUN1, life is extended to more than one year. Disruption of SUN1’s function is also accomplished by transducing and expressing a dominant-negative SUN1 miniprotein in Lmna deficient cardiomyocytes, using the cardiotrophic Adeno Associated Viral Vector 9. The SUN1 miniprotein disrupts binding between the endogenous LINC complex SUN and KASH domains, displacing the cardiomyocyte KASH complexes from the nuclear periphery, resulting in at least a fivefold extension in lifespan. Cardiomyocyte-specific expression of the SUN1 miniprotein prevents cardiomyopathy progression, potentially avoiding the necessity of developing a specific therapeutic tailored to treating each different LMNA cardiomyopathy-inducing mutation of which there are more than 450.

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Unsedated transnasalvideogastroscopy in the routine practice: One year experience on 1327 patients

Gastrointestinal Endoscopy ◽

10.1016/s0016-5107(01)80252-2 ◽

2001 ◽

Vol 53 (5) ◽

pp. AB128

Keyword(s):

Routine Practice ◽

One Year

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Sarcoidosis and Sarcoid Reactions in Endometrial Cancer Cases Masquerading Advanced Stage Malignancy

Current Women s Health Reviews ◽

10.2174/1573404817666210208163237 ◽

2021 ◽

Vol 17 ◽

Author(s):

Serkan Akis ◽

Canan Kabaca ◽

Esra Keles ◽

Handan Cetiner ◽

Hatice Akay

Keyword(s):

Endometrial Cancer ◽

Lymph Nodes ◽

Inflammatory Diseases ◽

Uterine Cavity ◽

Standardized Uptake Value ◽

Granulomatous Inflammation ◽

Pathological Examination ◽

Pet Ct ◽

Granulomatous Lesions ◽

Granulomatous Lymphadenitis

Background: Sarcoidosis is usually diagnosed by ruling out other granulomatous inflammatory diseases. Rarely, it may be suspected with a pathological examination after surgical intervention for another disease. The sarcoid reaction is noninfectious granulomatous lymphadenitis which can occur at nodes draining a neoplasm. We demonstrated granulomatous lesions masquerading metastasis by Positron Emission Tomography/Computed Tomography (PET/CT) in endometrial cancer. We presented two cases of endometrial cancer with sarcoidosis and sarcoid-like reactions because of their challenging clinical and radiological findings. Cases: In case 1, there was diffuse granulomatous inflammation (no metastasis) in lymph nodes (n=92) and giant cells containing calcifications (Schaumann bodies). In case 2, PET/CT revealed hypermetabolism with malignancy suspicion in the pelvic lymph nodes (maximum standardized uptake value= 13) and pathological evaluation reported a 4.5 cm tumor within the uterine cavity without any nodal metastasis. Results: PET/CT has no role in the evaluation of differential diagnosis between granulomatous lymphadenitis and metastatic disease. Conclusions: Granulomatous lesions might mimic the metastasis of coexisting malignant diseases.

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