Granulomatous skin inflammation - Revision history

Mikael Häggström: Expanded

2020-07-29T18:58:05Z

Expanded

← Older revision		Revision as of 14:58, 29 July 2020
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			==Microscopic examination==
			Granulomatous inflammation is defined by the presence of mononuclear leukocytes, specifically histiocytes, appearing as epithelioid cells with round to oval nuclei, often with irregular contours and abundant granular eosinophilic cytoplasm with indistinct cell borders. They may also coalesce to form multinucleated giant cells.<ref name="ShahPritt2017">{{cite journal\|last1=Shah\|first1=Kabeer K.\|last2=Pritt\|first2=Bobbi S.\|last3=Alexander\|first3=Mariam P.\|title=Histopathologic review of granulomatous inflammation\|journal=Journal of Clinical Tuberculosis and Other Mycobacterial Diseases\|volume=7\|year=2017\|pages=1–12\|issn=24055794\|doi=10.1016/j.jctube.2017.02.001}}</ref>

			===Differential diagnosis===
			*Other forms of '''[[dermatitis]]''' if other types of inflammatory cells are prevalent.
			*'''[[Suspected malignant skin excisions\|Suspected malignant skin lesions]]''' if demonstrating cellular atypia

			===Workup===
	*Look for '''foreign bodies''', conferring a diagnosis of ''foreign body granuloma''.		*Look for '''foreign bodies''', conferring a diagnosis of ''foreign body granuloma''.
	*Look for any specific '''appearance''' of the giant cells.		*Look for any specific '''appearance''' of the giant cells.
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	File:Histopathology of granulomatous inflammation by a ruptured inclusion cyst.jpg\|Granulomatious inflammation following an epidermal inclusion '''cyst rupture''', with giant cells surrounding keratin flakes.		File:Histopathology of granulomatous inflammation by a ruptured inclusion cyst.jpg\|Granulomatious inflammation following an epidermal inclusion '''cyst rupture''', with giant cells surrounding keratin flakes.
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Mikael Häggström: +rupture

2020-07-29T18:03:02Z

+rupture

← Older revision		Revision as of 14:03, 29 July 2020
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	File:Touton giant cell (annotated).jpg\|Appearance: A '''Touton giant cell''' contains a ring of nuclei surrounding a central homogeneous cytoplasm, with foamy cytoplasm surrounding the nuclei.<ref>{{cite book \| last = Grant-Kels \| first = Jane \| title = Color Atlas of Dermatopathology \| publisher = Informa Healthcare \| location = City \| year = 2007 \| isbn = 978-0-8493-3794-9 \| pages = 107, 119 }}</ref><ref>{{cite journal \|last1=Carmen Gómez-Mateo \|first1=Maria \|last2=Monteagudo \|first2=Carlos \|date=2013 \|title=Nonepithelial skin tumors with multinucleated giant cells \|url=http://www.semdiagpath.com/article/S0740-2570(12)00009-3/fulltext \|journal=Seminars in Diagnostic Pathology \|volume=30 \|issue=1 \|pages=58–72 \|pmid=23327730 \|doi=10.1053/j.semdp.2012.01.004}}</ref> The central cytoplasm (surrounded by the nuclei) may be both amphophilic and eosinophilic.<ref>{{cite journal \|last1=Sequeira \|first1=Fiona \|last2=Gandhi \|first2=Suneil \|date=2012 \|title=Named cells in dermatology \|url=http://www.ijdvl.com/article.asp?issn=0378-6323;year=2012;volume=78;issue=2;spage=207;epage=216;aulast=Sequeira \|journal=Indian Journal of Dermatology, Venereology and Leprology \|volume=78 \|issue=2 \|pages=207–16 \|doi=10.4103/0378-6323.93650 \|pmid=22421663}}</ref>		File:Touton giant cell (annotated).jpg\|Appearance: A '''Touton giant cell''' contains a ring of nuclei surrounding a central homogeneous cytoplasm, with foamy cytoplasm surrounding the nuclei.<ref>{{cite book \| last = Grant-Kels \| first = Jane \| title = Color Atlas of Dermatopathology \| publisher = Informa Healthcare \| location = City \| year = 2007 \| isbn = 978-0-8493-3794-9 \| pages = 107, 119 }}</ref><ref>{{cite journal \|last1=Carmen Gómez-Mateo \|first1=Maria \|last2=Monteagudo \|first2=Carlos \|date=2013 \|title=Nonepithelial skin tumors with multinucleated giant cells \|url=http://www.semdiagpath.com/article/S0740-2570(12)00009-3/fulltext \|journal=Seminars in Diagnostic Pathology \|volume=30 \|issue=1 \|pages=58–72 \|pmid=23327730 \|doi=10.1053/j.semdp.2012.01.004}}</ref> The central cytoplasm (surrounded by the nuclei) may be both amphophilic and eosinophilic.<ref>{{cite journal \|last1=Sequeira \|first1=Fiona \|last2=Gandhi \|first2=Suneil \|date=2012 \|title=Named cells in dermatology \|url=http://www.ijdvl.com/article.asp?issn=0378-6323;year=2012;volume=78;issue=2;spage=207;epage=216;aulast=Sequeira \|journal=Indian Journal of Dermatology, Venereology and Leprology \|volume=78 \|issue=2 \|pages=207–16 \|doi=10.4103/0378-6323.93650 \|pmid=22421663}}</ref>
	File:Histopathology of granulomatous folliculitis.jpg\|thumb\|Relation: '''Folliculitis''' with multinucleated giant cells surrounding a hair follicle.		File:Histopathology of granulomatous folliculitis.jpg\|thumb\|Relation: '''Folliculitis''' with multinucleated giant cells surrounding a hair follicle.
			File:Histopathology of granulomatous inflammation by a ruptured inclusion cyst.jpg\|Granulomatious inflammation following an epidermal inclusion '''cyst rupture''', with giant cells surrounding keratin flakes.
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Mikael Häggström: Started

2020-07-29T14:46:25Z

Started

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*Look for '''foreign bodies''', conferring a diagnosis of ''foreign body granuloma''.
*Look for any specific '''appearance''' of the giant cells.
*Look for '''relation''' to adnexae or other particular structures.
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File:Histopathology of suture granuloma.jpg|Foreign body: '''Suture''' granuloma, with multinucleated giant cells surrounding (grey) suture material.
File:Touton giant cell (annotated).jpg|Appearance: A '''Touton giant cell''' contains a ring of nuclei surrounding a central homogeneous cytoplasm, with foamy cytoplasm surrounding the nuclei.<ref>{{cite book | last = Grant-Kels | first = Jane | title = Color Atlas of Dermatopathology | publisher = Informa Healthcare | location = City | year = 2007 | isbn = 978-0-8493-3794-9 | pages = 107, 119 }}</ref><ref>{{cite journal |last1=Carmen Gómez-Mateo |first1=Maria |last2=Monteagudo |first2=Carlos |date=2013 |title=Nonepithelial skin tumors with multinucleated giant cells |url=http://www.semdiagpath.com/article/S0740-2570(12)00009-3/fulltext |journal=Seminars in Diagnostic Pathology |volume=30 |issue=1 |pages=58–72 |pmid=23327730 |doi=10.1053/j.semdp.2012.01.004}}</ref> The central cytoplasm (surrounded by the nuclei) may be both amphophilic and eosinophilic.<ref>{{cite journal |last1=Sequeira |first1=Fiona |last2=Gandhi |first2=Suneil |date=2012 |title=Named cells in dermatology |url=http://www.ijdvl.com/article.asp?issn=0378-6323;year=2012;volume=78;issue=2;spage=207;epage=216;aulast=Sequeira |journal=Indian Journal of Dermatology, Venereology and Leprology |volume=78 |issue=2 |pages=207–16 |doi=10.4103/0378-6323.93650 |pmid=22421663}}</ref>
File:Histopathology of granulomatous folliculitis.jpg|thumb|Relation: '''Folliculitis''' with multinucleated giant cells surrounding a hair follicle.
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