A special form of chronic inflammation. It is formed most often when either a
foreign body or persistent microorganism, such as the tubercle bacillus, evades
destruction by the unmodified chronic inflammatory response. In its most
classical form, a granuloma consists of concentric layers of cells that,
together, form the distinctive lesion. At the center, there often is a focus of caseous
necrosis, although this need not be the case. This central focus is
surrounded by a layer of specialized macrophages, called epithelioid
cells, and multinucleated giant cells. The latter form
as the result of cytoplasmic fusion of macrophages, due to stimulation by a cytokine.
The next layer is predominantly lymphocytes, and the
outer layer is most often fibroblasts, that are attempting to wall off the
inciting stimulus with fibrous connective tissue. Granulocytes,
plasma cells, and other cells types may also be present.
If the agent is an inert foreign body, the granuloma will be of the nonimmune
type. However, if the inciting agent is antigenic, the lesion will be an immune
type of granuloma, in which the antigen-stimulated lymphocytes are producing
cytokines, such as interferon-gamma, to activate the macrophages and their
specialized forms to heightened levels of microbicidal activity.
See Also:
See Also:
See Also:
See Also:
See Also:
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