Granuloma

Introduction Granuloma is a well-defined nodular lesion composed of local hyperplasia of macrophages. The lesion is small and generally has a diameter of 0.5-2 mm. Inflammation characterized by granuloma formation is called granulomatous inflammation, and macrophages activated in granuloma often have epithelial-like morphology. Different causes often cause different forms of granuloma, pathologists often make a diagnosis based on the morphological characteristics of granulomas. Typical tuberculous granuloma can diagnose tuberculosis. If the granulomatous morphology is atypical, it is often necessary to supplement with special tests such as acid-fast staining, bacterial culture, serological examination and polymerase chain reaction (PCR).

Cause

1. Tumor-like theory:

Similar to reticulum cell sarcoma or lymphoma, there are tumor-like hyperplasia of heterogeneous cells and dividing phases, no necrotizing blood vessels and multinucleated giant cells. The disease is limited to the nose and respiratory tract. In the late stage of the disease, the same lesions can be seen in the body such as internal organs, lymph nodes and bone marrow. Therefore, it is very similar to the metastasis of malignant tumors. Some patients can be cured by radiotherapy, which is consistent with oncology theory.

2. Allergies or autoimmunity:

There is immunoglobulin deposition in the capillary wall, and immune complexes appear in the serum of patients with active disease, treated with immunosuppressive agents, and disappear when symptoms are relieved. Immunofluorescence test showed that there were C3 and lgG in the glomerular basement membrane. Electron microscopy showed that the basement membrane had the same coarse granular material as the immune complex, and the ring immune complex was elevated; all of them were autoimmune diseases.

3, bacterial virus infection theory:

Recent studies have found that bacteria and virions are found in cell cultures and sera in patients taking granulomatous tissue, so it is thought to be related to bacterial infection.

an examination

Related inspection

Nitrotetrazolidine blue test biochemical examination X-ray lipiodol angiography CT examination syphilis hemagglutination test

1. Pathological biopsy: presents chronic non-specific granulomatous lesions.

2, laboratory tests: white blood cell count is low, erythrocyte sedimentation rate is accelerated; immunoglobulin levels are high, bacteria, fungi and virus culture have many special findings.

3. Tomographic X-ray film and CT scan.

Differential diagnosis

Clinically and tumor identification:

Tumor tissue is composed of cancer cells and interstitial cells, which are abnormally proliferating cells transformed by normal cells. Tumors can occur in many organs and tissues of the human body. According to the size of the tumor and its growth characteristics, it is divided into benign tumors and malignant tumors. Benign tumors grow slowly and have swelling growth. The surface often has a complete capsule. It has fewer systemic symptoms except local symptoms. It does not infiltrate into the surrounding tissues and does not metastasize to the whole body. It is not easy to recur after surgical resection, and it is less harmful to the body. Lipoma, hemangioma, adenoma, cyst, etc. Malignant tumors grow rapidly, often infiltrate into surrounding tissues during growth, and there are few capsules on the surface, often with systemic metastasis. Pathological examination shows atypical mitosis. In addition to local symptoms, systemic symptoms are obvious. Late stage patients often have cachexia, recurrence rate after surgical resection. High, harmful to the body, such as bone cancer, esophageal cancer, liver cancer, lung cancer, leukemia, osteosarcoma. The incidence of malignant tumors has been increasing year by year, and it is also among the top causes of death of various diseases, and thus it is a disease that is mainly controlled. Benign tumors can sometimes be converted to malignant, called malignant transformation of benign tumors, such as fibroids can be converted into fibrosarcoma. Some diseases are easily converted into malignant tumors, such as atrophic gastritis can develop into gastric cancer; junctions can develop into malignant melanoma, these diseases are called precancerous diseases or precancerous lesions.

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