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Characteristic of granuloma | Description | Etiologic causes |
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With necrosis | Macrophages, multinucleated giant cells, lymphocytes, and central necrosis; calcifications may be present | Tuberculosis, chronic fungal infections (such as histoplasmosis, coccidioidomycosis, blastomycosis), Wegener's granulomatosis |
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With necrosis and eosinophils | Macrophages, multinucleated giant cells, lymphocytes, eosinophils, and necrosis | Parasites (including schistosomiasis, fasciolosis), sometimes some of the chronic fungal infections mentioned above |
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With stellate or geographic necrosis | Macrophages, multinucleated giant cells, lymphocytes, neutrophils, central necrosis that takes a stellate shape | Tularemia, bartonellosis, lymphogranuloma venereum, actinomycosis, chronic granulomatous disease |
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With suppurative inflammation | Macrophages, lymphocytes, abundant neutrophils, and different amounts of necrosis | Tularemia, listeriosis, acute fungal infections |
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With abundant plasma cells | Macrophages, multinucleated giant cells, lymphocytes, plasma cells, and different amounts of necrosis | Syphilis |
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Foamy macrophage aggregates | Foamy macrophages with minimal necrosis and other inflammatory cells | Atypical mycobacteria (MAI), Whipple disease, Rhodococcus equi, lepromatous leprosy |
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Epithelioid granuloma with minimal or no necrosis | Small, macrophages, multinucleated giant cells, lymphocytes | Leishmaniasis, sarcoidosis, lupus, hepatitis C |
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Epithelioid granuloma with minimal or no necrosis but presence of eosinophils | Small, macrophages, multinucleated giant cells, lymphocytes, eosinophils | Rejection after transplant, response to medications |
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Ill defined | Small groups of macrophages | Hodgkin's disease, metastasis |
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Lipid granulomas | Macrophages with lipid vacoules, lymphocytes, may have some necrosis including fibrin deposition | Lipid containing foods, mineral oils, reactions to medications, toxoplasmosis |
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Granulomas with a vacuole surrounded by fibrin | Macrophages, multinucleated giant cells, lymphocytes, neutrophils, lipid vacuole (clearing) surrounded by fibrin | Q fever, rarely: leishmaniasis, toxoplasmosis, cytomegalovirus, typhoid |
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