GRANULOMATOUS REACTIONS IN VARIOUS ORGANS AND SYSTEMS

                               GRANULOMATOUS REACTIONS IN VARIOUS ORGANS AND SYSTEMS

• SKIN

1. 1. Infectious – TB, leprosy, cryptococossis, shistosomiasis, sporothrix,  secondary syphilis

   2. Due to exogenous and endogenous materials like silica, beryllium, zirconium, tattoo pigments, talc , starch

   3. Lichen nitidus

   4.  Sarcoidosis

   5. Granulomatous vasculitis

   6. Fungal folliculitis ( Majocchi syndrome)

   7. Acne rosacea 

   8. Cutaneous gout

   9. Subcutaneous fat necrosis of newborn

   10. Pancreatic fat necrosis panniculitis

   11. Thymic cyst

   12. Granulomatous type of mycosis fungoides

• MUSCLE :-

1. 1. Granulomatous myopathy ( Trichinella infection) 

• BONE :-

1. 1. Fungal infections – Blastomycosis, coccidiodomycosis, cryptococcosis, sporotrichosis

   2. Sarcoidosis

   3. TB

• BREAST :-

1. 1. Granulomatous mastitis 

   2. Foreign body gaint cell reaction

   3. Sarcoidosis

   4. Galactocele

   5. Infiltrating ductal carcinoma NOS

   6. Fat  necrosis

• CENTRAL NERVOUS SYSTEM :-

1. 1. Bacterial – TB, syphilis, whipple disease

   2. Fungal – Cryptococcus 

   3. Parasitic infections – neurocysticercosis, acanthamoeba

   4. SLE

   5. Sarcoidosis

   6. Rheumatoid meningitis

   7. Crohn disease

   8. Granulomatous angitis

   9. Granulomatous hypophysitis

   10. Amyloid angiopathy

   11. Intracranial germinoma

• THYROID :-

1. 1. Granulomatous thyroiditis

   2. Palpation thyroiditis 

• BONE MARROW :-

1. 1. Bacterial – TB, Leprae, syphilis, Rickettsial infections, Avium intracellulare, Tularemia, Typhoid, Brucellosis, Borreliosis, Qfever, Mycoplasma

   2. Fungal – Histoplasmosis, Cryptococcosis, Coccidiodomycosis,Aspergillosis, Blastomycosis, EBV, cytomegalovirus, Hepatitis C virus, HIV/AIDS

   3. Parasite – Toxoplasmosis

   4. Bacillus calmitte Guerin induced 

   5. Malignancies – Hodgkin lymphoma , Non Hodgkin lymphoma, Myeloma, ALL,AML,CML,MDS, Colon carcinoma, Lung carcinoma, Ovarian carcinoma, Neuroblastoma, Sarcoma

   6. Autoimmune disorders – Rheumatoid arthritis, Felty syndrome, Primary biliary cirrhosis, Sjogren syndrome, Pulmonary fibrosis, SLE, Addisons syndrome, Behcets syndrome, Temporal arteritis, Post transplantation, Erythema nodosum

   7. Drug induced – NSAIDS, Analgesics, Chemotherapy, Cytokines, Antibiotics, Antiepileptics, Antiarrythmics

   8. Foreign body induced – Pnemoconiosis, silicosis, IV drug abuse

• LYMPHNODE :-

1. 1. Cat scratch disease

   2. Syphilis

   3. Whipples disease

   4. Sarcoidosis

   5. Hodgkin lymphoma

   6. Metastasis (Seminoma)

• SPLEEN :-

1. 1. Chronic lymphocytic leukemia / small lymphocytic lymphoma

   2. Splenic marginal zone lymphoma

   3. Lymphoplasmacytic lymphoma

   4. Hodgkin lymphoma

   5. Hairy cell leukemia

   6. Inflammatory pseudotumor of spleen

• JAWS AND ORAL CAVITY :-

1. 1.       Peripheral giant cell granuloma

• HEAD AND NECK :-
  • SALIVARY GLANDS :-

1. 1. 1. Granulomatous sialadenitis

      2. TB

      3. Tuberculoid form of leprosy

1. • NOSE , PARANASAL AND NASOPHARYNX :-

1. 1. 1. Wegners granulomatosis

      2. Sarcoidosis

      3. Gaint cell granuloma

      4. Plasma cell granuloma

      5. Steroid injections induced

• • LARYNX :-

1. 1. 1. Bacterial – TB, secondary syphilis

      2. Fungal – Histoplasmosis, Blastomyces dermatiditis

      3. Sarcoidosis

      4. Endotracheal anaesthesia induced

• • EAR :-

1. 1. 1. Cholesterol granuloma

      2. Granulomatous external otitis

• • EYE :-

1. 1. 1. Bacterial – TB, treponema pallidum

      2. Fungi – aspergillus, Blastomyces dermatididtis, Candida, Coccidiodes Immites, Histoplasma capsulatum, Sporothrix schenki

      3. Parasites – Toxocara canis, Taenia solium

      4. Idiopathic – sarcoidosis, Vogt koyanagi Harada syndrome

      5. Immunological – Juvenile rheumatoid arthritis, Symphatetic uveitis

      6. Chalazion 

      7. Rupture of epidermal inclusion cyst , Dermoid cyst

• LUNG :-

1. •  INFECTIOUS :-

     1. Tuberculosis 

     2. Histoplasmosis 

     3. Paracoccidioidomycosis

     4. Mycetoma

     5. Ascardiasis 

     6. Echiococcosis 

     7. Dirophilariosis 

• • NON – INFECTIOUS :-

1. 1. 1. Hypersensitivity  pneumonia 

      2. Histiocytosis – X

      3. Vasculitis 

      4. Lymphomas 

      5. Sarcoidosis 

      6. Pneumoconiosis (silicosis and berylliosis)

• MEDIASTINUM :- 

1. 1. 1. Cholesterol granulomas 

      2. Sclerosing mediastinitis 

      3. Hodgkin disease of thymus 

• HEART :- 

1. 1. 1. Hypersensitivity myocarditis 

      2. Acute rheumatic fever 

      3. Sarcoidosis 

      4. Coccidioides imitis 

      5. Wegners grnulomatosis

• BLOOD VESSELS :- 

1. 1. 1. Necrotising aortitis 

      2. Giant cell arteritis 

      3. Wegners granulomatosis 

      4. Churg – strauss angitis 

      5. Sarcoid vasculitis 

• GASTROINTESTINAL TRACT:- 

1. • ESOPHAGUS :- 

• • • Crohn disease of esophagus 
  • STOMACH :- 

1. 1. 1. Isolated granulomatous gastritis 

      2. Crohn disease 

      3. Sarcoidosis 

      4. Eosinophilic gastritis 

      5. Tuberculosis 

      6. Fungal causes 

• • COLON :- 

1. 1. 1. Crohn disease 

      2. Barium granuloma 

      3. Bacterial causes includes TB, syphilis , Chlamydia ,yesrsinia

      4. Crohn  disease of appendix 

• • ANUS :-

    1. Anal fissure 

    2. Crohn disease 

• PANCREAS :- 

  1. 1. Lipogranuloma 

     2. Granulomatous pancreatitis 

• LIVER:- 

  • 1. Chronic granulomatous disease of childhood 

    2. Crohns disease 

    3. Foreign material induced granulomas 

    4. Sarcoidosis 

    5. Primary biliary cirrhosis

    6. Lipogranulomas 

    7. Hepatocellular adenoma 

    8. Hodgkin disease 

  • Infectious 

    1. Bacteria :- brucella , listeria, rickkettsia, tuberculosis 

    2. Fungi :- histoplasmosis , asperigillus , candida

    3. Parasite :- schistosomiasis 

    4. Viral :- HCV, EBV, CMV

• GENITO URINARY TRACT :- 

  • KIDNEY :- 

    1. Glomerulo nephritis

    2. Acute interstitial nephritis 

    3. Cresentic  Gout 

    4. Wegners granulomatosis

  • URINARY BLADDER :- 

    1. After BCG therapy

    2. Tuberculous cystitis 

    3. Tuberculous prostatitis 

    4. Allergic granulomatous prostatitis 

• MALE GENITAL TRACT :- 

  • TESTIS :- 

    1. Vasculitis nodosum

    2. Wegners granulomatosis

    3. Granulomatous orchitis 

    4. Epidermoid and dermoid cyst 

    5. Spermatic cord granulomas of epididymis

    6. Seminoma 

    7. Teratoma 

    8. Spermatocytic seminoma 

  • PENIS :- 

    1. Lymphogranuloma venerum 

    2. Wegners granulomatosis 

    3. Mycobacterial infection of penis 

•      FEMALE GENITAL TRACT :- 

  • VULVA :-

    1. Pilonidal sinus 

    2. Granuloma inguinale 

    3. Lymphogranuloma venerum 

    4. Sclerosing lipogranuloma 

    5. Crohn vulvitis 

  • ENDOMETRIUM :- 

    1. Granulomatous endometritis 

    2. Secondary to laser ablation 

• OVARY :- 

  1. Mucin granuloma 

  2. Clear cell carcinoma 

  3. Yolk sac tumor 

  4. Teratoma 

  5. Suture material 

  6. Infections – schistosomiasis , enterobius, tuberculosis

  7. Granulomatous oophoritis 

• FALLOPIAN TUBE :- 

  1. Granulomatous salpingitis 

  2. Foreign body salpingitis 

  3. Crohns disease 

  4. Sarcoidosis

  5. Infectious :-

     • Fungal :- blastomycosis, coccidiodmycosis

     • Parasite :- schistososma

•  PLACENTA: – Granulomatous vilitis 

•  PERITONEUM :-

1. 1. Granulomatous peritonitis 

   2. Peritoneal  keratin  granuloma 

   3. Infectious

      1. Fungal :- Histoplasmosis , Coccidiodomycosis, Cryptococcosis 

      2. Parasite :- Schistosomiasis, Ascariasis, Strongyloides, Echinococcus, Oxyuriasis

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