Granuloma caseating

Colonoscopy patchy "cobblestone" inflammation in the terminal ileum and ascending colon with evidence of recent bleeding, (-) polyps or strictures, biopsy taken Path Evidence of disease extension to muscularis with non-caseating granulomas... 

About 10% of infected patients develop reactivation TB, with half occurring in the first 2 years after infection.2 6 12 Upper lobe pulmonary disease is the most common (85% of cases).2 Caseating granulomas result from the vigorous immune response, and liquefaction leads to local spread. Eventually, a pulmonary cavity results, and this provides a portal to the outside that allows for person-to-person spread. Bacterial counts in the cavities can be as high 1011 per liter of cavitary fluid (108 per milliliter).2,15 Prior to the chemotherapy era, pulmonary TB usually was associated with hypoxia, respiratory acidosis, and eventually death. 

Caseating granulomas, regardless of location, can undergo liquefaction, spread tubercle bacilli and cause symptoms.2,6 Because of muted or altered symptoms, the diagnosis of TB is difficult and often delayed in immunocompromised hosts.2,3,6 HIV-infected patients may present with only extrapulmonary TB, which is very uncommon in HIV-negative persons. A widely disseminated form of the disease called miliary TB can occur, particularly in children and immunocompromised hosts, and it can be rapidly fatal.17 Immediate treatment is required. 

Caseating granulomas A mass or nodule of chronically inflamed tissue with granulations, usually associated with an infective process. 

Bone marrow biopsy in a patient taking amiodarone 100 mg/day showed multiple non-caseating epithelioid granulomata, which resolved 3 months after the withdrawal of amiodarone in a 67-year-old man (167). Similar granulomas were found in a 77-year-old woman who had taken amiodarone 100 mg/day for many years and had thrombocytopenia the bone marrow contained an increased number of megakaryocytes. Her platelet count normalized 1 month after... 

Micro caseating granulomas with acid-fast bacilli Lab positive skin test (PPD)... 

The histological appearance of chronic heryllium disease is indistinguishable from that of sarcoidosis, with non-caseating granulomas accompanied by mononuclear cell infiltrates and variable interstitial fibrosis (Maier 2002a). The granulomas are... 

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