1
GranulomasGranulomas•Definition•Pathogenesis•Classification•A,B,C’s of granulomas
macrophage(“epithelioid
cell”)
T-lymphocyte
multinucleatedgiant cell
Granuloma: a closely apposed collection of activated macrophages interacting with other immune cells (T-cells, sometimes eosinophils) in the process of degrading an indigestible antigen OR as a type IV hypersensitivity response
antigen
2
3
4
5
6
7
8
9
10
CD4 Th1
Th0
Th2
IFN-γ
ROS
lysosomalenzymes
granuloma
65
4
3
2
1
IL-2
IL-12
11
CD4 T-lymphocyte
macrophage
dendritic cell CD8 T-lymphocyte
eosinophil
Th2 cytokinesTh1 cytokines
GRANULOMA: generalized structure
TNF-αIFN-γIL-12iNOSIL-2
IL-4IL-5IL-10IL-13
ovum
eosinophil-richmacrophage-rich
Tuberculosis Schistosomiasis
12
13
14
15
16
17
18
19
20
21
22
23
NN
Birbeck Granule
24
25
26
27
28
29
30
Asteroid body
31
Schaumann body
32
33
34
35
36