Granuloma

A granuloma is a specialized form of chronic inflammation characterized by the formation of compact, often microscopic, nodules. These structures, which primarily consist of macrophages and other immune cells, are typically seen in tissues affected by certain persistent infections, inflammation, or injuries. Granulomas function as a part of the body's immune response, seeking to isolate foreign substances or irritants that the body is unable to eliminate.<ref name="Ramakrishnan">Ramakrishnan, L.,

 Revisiting the role of the granuloma in tuberculosis, 
 Nature Reviews Immunology, 
 
 Vol. 12,
 pp. 352–366,
 DOI: 10.1038/nri3211,</ref>

Tropical Diseases - Fig 94

Granuloma mac

Pathophysiology

Granulomas form when the immune system attempts to wall off substances that it perceives as foreign but is unable to eliminate. Such substances can include infectious organisms, such as bacteria or fungi, or non-infectious irritants, such as silica dust or certain types of medical implants.

The granuloma starts to develop as immune cells, particularly macrophages, surround and attempt to destroy the foreign material. If the material is not easily eliminated, a persistent immune response ensues. Over time, the macrophages in the area may fuse to form multinucleated giant cells, and other immune cells, such as lymphocytes, may also congregate. This aggregation of cells evolves into a granuloma.<ref name="Paleri">Paleri, V.,

 Granulomatous disorders of the head and neck, 
 Current Opinion in Otolaryngology & Head and Neck Surgery, 
 
 Vol. 11,
 pp. 145–150,
 DOI: 10.1097/00020840-200306000-00007,</ref>

Clinical Manifestations

Clinically, granulomas can present in various ways depending on their location and cause. In many cases, granulomas may not cause any symptoms and may only be discovered incidentally during investigations for other conditions. In other cases, granulomas may cause local symptoms due to their size or location or systemic symptoms related to the underlying disease process that caused them to form.

Diagnosis and Management

The diagnosis of a granuloma typically involves histological examination of tissue obtained via biopsy. This allows the pathologist to visualize the characteristic structure of a granuloma and may also provide clues as to its cause.

Management of granulomas depends largely on the underlying cause. In some cases, such as when granulomas are caused by treatable infections, treating the infection may lead to resolution of the granulomas. In other cases, management may involve monitoring the granulomas for signs of progression or complications.<ref name="Paleri"/>

Conclusion

Granulomas play a critical role in the body's immune response to persistent irritants or infections. Understanding the process of granuloma formation and its implications is essential to the diagnosis and management of many different disease processes.

See Also

• Immune response
• Inflammation
• Infection

References

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