Granuloma - Caseating, Non-caseating, Epithelioid Cells (Histiocytes) - Tuberculoma, Leproma Gumma

Granuloma - Caseating, Non-caseating, Epithelioid Cells (Histiocytes) - Tuberculoma (of tuberculosis), Leproma (of leprosy), and Gumma (of syphilis).
Granuloma (type IV Hypersensitivity Reaction - Delayed hypersensitivity reaction) is formed by macrophages (epithelioid cells or epithelioid histiocytes), T-lymphocytes (T-Helper cells), and fibroblasts. Antigen presenting cells (APCs) present the antigen to the T-lymphocyts (Th1) which secretes interferon-gamma to activate the macrophages. Activated macrophages secrete tissue necrosis factor (TNF) to form and sustain a granuloma. Epithelioid cells fuse together to form multi-nucleated giant cells (Langhans cell). Biological DMARDs (TNF inhibitors) can cause the granuloma to break down. Pathology lectures for doctors, nurses, MBBS.
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