granulomatous diseases dr shaesta naseem 24-10-13
TRANSCRIPT
![Page 1: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/1.jpg)
Granulomatous diseases
Dr Shaesta Naseem24-10-13
![Page 2: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/2.jpg)
Gross and histopathology
![Page 3: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/3.jpg)
1- Tuberculosis of the lung
![Page 4: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/4.jpg)
Ghon’s Complex (Lung)
Caseous necrosis(Yellowish areas )
Ghon’s complex consist of Ghon focus in the lung and lymphadenopathy.
![Page 5: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/5.jpg)
Primary necrosis(primary: because it is down)
Miliary TB of the Lungs
![Page 6: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/6.jpg)
Caseous necrosis
Diagnosis: TB in the lung
![Page 7: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/7.jpg)
Organ: lung Dx : Caseous necrosis (tuberculosis)
![Page 8: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/8.jpg)
Tuberculous Granulomas
Gaint cellAreolar spaces in the lung.
We see under the Microscope:1- Epithlioid histocytes “Bottle-shaped”.2-Gaint cell.3-centeral caseous necrosis.4-lymphocytes and plasma cells.
![Page 9: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/9.jpg)
Caseation Necrosis
Epitheloid cells
![Page 10: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/10.jpg)
Epitheloid cells in Granuloma
lymphocytes
Langhan's giant cell
![Page 11: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/11.jpg)
Necrotizing (i.e., caseating) granulomas filled with acid fast bacilli. This is CLASSIC for TB.
![Page 12: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/12.jpg)
MORE ACID-FAST BACILLI, AFB *The name of the stain (AFB).OR Ziehl-Neelsen stain
![Page 13: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/13.jpg)
tuberculosis of the lung :
• Section of the lung shows : The alveolar septae contain many tubercles which consist of epithelioid cells , few langhan’s giant cells and peripheral rim of lymphocytes with or without caseation
![Page 14: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/14.jpg)
2- Tuberculous lymphadenitis
Clinical features:1-night fever.2-rise of temperature.3-hemoptisis. 4-cough .
![Page 15: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/15.jpg)
Enlarged limph node
There is no Areolar paces ,therefore it is not Lung
![Page 16: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/16.jpg)
Lymphocytes AndPlasma cells
Gaint cells(Horse U shape)
Epitheliod cells
Caseated necrosis
![Page 17: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/17.jpg)
Caseated necrosis
![Page 18: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/18.jpg)
Tuberculous lymphadenitis :Section of a lymph node with connective tissue
capsule and lymphoid tissue shows:
Many round and oval tubercles/ granulomas with or without central caseation that appears structureless, homogenous and pink in colour.
The granulomas consists of epithelioid cells, few langhan’s giant cells (large cell with multiple peripheral nuclei) and peripheral rim of lymphocytes.
![Page 19: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/19.jpg)
3- Bilharziasis of the colon
Intestine & bladder
![Page 20: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/20.jpg)
There are five species of flatworms that cause schistosomiasis. Each causes different symptoms.Schistosomiasis may travel to different parts of the body, and its localization determines the person's symptoms.1. Schistosoma mansoni and Schistosoma japonicum
cause intestinal schistosomiasis.2. Schistosoma haematobium causes urinary
schistosomiasis.
Schistosomiasis or bilharzia is a disease affecting many people in developing countries. In the form of 'acute' schistosomiasis it is
sometimes referred to as snail fever and cutaneous schistosomiasis
![Page 21: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/21.jpg)
Schistosomiasis life cycle.
• Schistosomes have a trematode vertebrate-invertebrate lifecycle (infecting both a vertebrate and invertebrate), with humans being the definitive host
• The life cycles of all human schistosomes are similar: parasite eggs are released into the environment from infected individuals. The eggs hatch on contact with fresh water to release the free-swimming miracidium
![Page 22: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/22.jpg)
![Page 25: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/25.jpg)
BILHARZIASIS (COLON)
OvaSurrounded by granuloma tissue (ova=egg=shell)
Symptoms:1-fever2-bleeding3-itching.
![Page 26: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/26.jpg)
SCHISTOSOMIASIS OF THE URINARY BLADDER (Bladder cancer)
Ova of Schistosomiasis
Spikes: determine the type of bilharziasis
![Page 27: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/27.jpg)
Bilharziasis of the rectum\urinary bladder:Section of fragments of rectal\urinary bladder mucosa shows:
Many Bilharzial ova with yellow brown shells in mucosa and submucosa surrounded by fibrosis and chronic inflammatory cells consisting of lymphocytes, plasma cells and many eosinophils.
Few granulomas are seen around the ova.
![Page 28: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/28.jpg)
5- Cutaneous leishmaniasis
![Page 29: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/29.jpg)
Leishmaniasis
• Protozoal disease.
• transmitted to human via the bite of the female sandfly
• Animal reservoir is required to persist.
![Page 30: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/30.jpg)
Leishmaniasis Life cycle
![Page 31: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/31.jpg)
Description:-Fllcerated crusted lesion-Also there is hemorrage
Only in the skin
![Page 32: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/32.jpg)
Collection of macrophages (engulf particles)
epidermis
Many macrophages with engulfed organism.
![Page 33: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/33.jpg)
Histological view shows marked cellular infiltration and parasites (Leishman bodies) within macrophages
macrophages
Leishman bodies
![Page 34: Granulomatous diseases Dr Shaesta Naseem 24-10-13](https://reader036.vdocuments.net/reader036/viewer/2022062519/56649ebe5503460f94bc8010/html5/thumbnails/34.jpg)
Picture shows a macrophage containing Leishmania amastigotes with characteristic features (round nucleus, rod-shaped kinetoplast; arrows) .
Leishman bodiesAmastigotes
kinetoplast