granulomatous diseases and malignant infections. od

8/16/2019 Granulomatous Diseases and Malignant Infections. OD

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Granulomatous Diseases

Photomicrograph of a granulomatous inammatory reaction showingmultiple granulomas surrounded by lymphocytes. Each granuloma iscomposed predominantly of epithelioid macrophages andmultinucleated giant cells. Epithelioid macrophages show abundantpale pink cytoplasm vesicular and oval nuclei and indistinct cellborders.

-These are heterogeneous group of disorders that are characterized bya specic pattern of chronic inammation called granulomatousinammation in which granulomas are formed.

-!ranulomas usually develop as a result of a cell-mediatedhypersensitivity reaction to a non-degradable antigen.

-"omposed predominantly of epithelioid macrophages which may besurrounded by a rim of lymphocytes and#or plasma cells.



-!ranulomas can be classied as immune or foreign body type.

• $oreign body type granulomas develop in response to inert

endogenous or e%ogenous foreign material.

• &mmune-mediated granulomatous inammation represents a

form of delayed type 'cell-mediated( hypersensitivity reactionand may be secondary to specic types of bacterial fungal andparasitic infections.



Tuberculosis

-&s a common worldwide infection caused by bacteria )ycobacteriumtuberculosis.-&t usually a*ects the lungs+ it may also involve other organs in up to

one-third of cases.- Tuberculosis is a disease of poverty associated with overcrowding andunder nutrition.- ,ased on orld ealth /rganization '/( estimates appro%imatelytwo billion people or one-third of the world0s total population wereinfected with M. tuberculosis in 1232 with 3.4 million deaths caused bytuberculosis yearly.-The disease is usually transmitted by the airborne spread of dropletnuclei produced by patients with infectious pulmonary tuberculosis



Oral manifestations.

-"hronic painless ulcer. &t usually involves the gingiva mucobuccal foldand areas of inammation ad5acent to teeth or in e%traction sites.-Primary oral lesions are fre6uently accompanied by enlarged regionallymph nodes

Diagnosis.7 presumptive diagnosis of active tuberculosis is commonly made onthe nding of acid-fast bacilli on microscopic e%amination of adiagnostic specimen such as a tissue biopsy or a smear ofe%pectorated sputum.

Management -7ntitubercular therapy for 38 to 14 months should be instituted.



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granulomatous diseases and malignant infections. od

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