Abstract
Granulomatous disorders comprise a large family sharing the histological denominator of granuloma formation. A granuloma is a focal compact collection of inflammatory cells, mononuclear cells predominating, usually as a result of the persistence of a non-degradable product and of active cell mediated hypersensitivity. There is a complex interplay between invading organism or prolonged antigenaemia, macrophage activity, a Th1 cell response, B cell overactivity and a vast array of biological mediators. Differential diagnosis and management demand a skilful interpretation of clinical findings and pathological evidence. They are classified into infections, vasculitis, immunological aberration, leucocyte oxidase deficiency, hypersensitivity, chemicals, and neoplasia. Keywords: granuloma; Th1 cell; cytokines; neoplasia
Full Text
The Full Text of this article is available as a PDF (150.8 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Armstrong L., Foley N. M., Millar A. B. Inter-relationship between tumour necrosis factor-alpha (TNF-alpha) and TNF soluble receptors in pulmonary sarcoidosis. Thorax. 1999 Jun;54(6):524–530. doi: 10.1136/thx.54.6.524. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Blau E. B. Familial granulomatous arthritis, iritis, and rash. J Pediatr. 1985 Nov;107(5):689–693. doi: 10.1016/s0022-3476(85)80394-2. [DOI] [PubMed] [Google Scholar]
- Curnutte J. T. Chronic granulomatous disease: the solving of a clinical riddle at the molecular level. Clin Immunol Immunopathol. 1993 Jun;67(3 Pt 2):S2–15. doi: 10.1006/clin.1993.1078. [DOI] [PubMed] [Google Scholar]
- James D. G. What makes granulomas tick? Thorax. 1991 Oct;46(10):734–736. doi: 10.1136/thx.46.10.734. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Jansen T., Plewig G. Rosacea: classification and treatment. J R Soc Med. 1997 Mar;90(3):144–150. doi: 10.1177/014107689709000308. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Kuo T. T. Kikuchi's disease (histiocytic necrotizing lymphadenitis). A clinicopathologic study of 79 cases with an analysis of histologic subtypes, immunohistology, and DNA ploidy. Am J Surg Pathol. 1995 Jul;19(7):798–809. doi: 10.1097/00000478-199507000-00008. [DOI] [PubMed] [Google Scholar]
- Larsson E., Westermark P. Chronic hypertrophic vulvitis--a condition with similarities to cheilitis granulomatosa (Melkersson-Rosenthal syndrome). Acta Derm Venereol. 1978;58(1):92–93. [PubMed] [Google Scholar]
- Lim S. H., Stephens P., Cao Q. X., Coleman S., Thomas D. W. Molecular analysis of T cell receptor beta variability in a patient with orofacial granulomatosis. Gut. 1997 May;40(5):683–686. doi: 10.1136/gut.40.5.683. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Reiser H., Stadecker M. J. Costimulatory B7 molecules in the pathogenesis of infectious and autoimmune diseases. N Engl J Med. 1996 Oct 31;335(18):1369–1377. doi: 10.1056/NEJM199610313351807. [DOI] [PubMed] [Google Scholar]
- Roman J., Jeon Y. J., Gal A., Perez R. L. Distribution of extracellular matrices, matrix receptors, and transforming growth factor-beta 1 in human and experimental lung granulomatous inflammation. Am J Med Sci. 1995 Mar;309(3):124–133. doi: 10.1097/00000441-199503000-00002. [DOI] [PubMed] [Google Scholar]
- Schapiro B. L., Newburger P. E., Klempner M. S., Dinauer M. C. Chronic granulomatous disease presenting in a 69-year-old man. N Engl J Med. 1991 Dec 19;325(25):1786–1790. doi: 10.1056/NEJM199112193252506. [DOI] [PubMed] [Google Scholar]
- Spapen H. D., Segers O., De Wit N., Goossens A., Buydens P., Dierckx R., Somers G. Electron microscopic detection of Whipple's bacillus in sarcoidlike periodic acid-Schiff-negative granulomas. Dig Dis Sci. 1989 Apr;34(4):640–643. doi: 10.1007/BF01536345. [DOI] [PubMed] [Google Scholar]
- Thrasher A. J., Casimir C. M., Kinnon C., Morgan G., Segal A. W., Levinsky R. J. Gene transfer to primary chronic granulomatous disease monocytes. Lancet. 1995 Jul 8;346(8967):92–93. doi: 10.1016/s0140-6736(95)92116-8. [DOI] [PubMed] [Google Scholar]
- Wiesenfeld D., Ferguson M. M., Mitchell D. N., MacDonald D. G., Scully C., Cochran K., Russell R. I. Oro-facial granulomatosis--a clinical and pathological analysis. Q J Med. 1985 Jan;54(213):101–113. [PubMed] [Google Scholar]
- Zumla A., James D. G. Granulomatous infections: etiology and classification. Clin Infect Dis. 1996 Jul;23(1):146–158. doi: 10.1093/clinids/23.1.146. [DOI] [PubMed] [Google Scholar]