Pathology Cheat Sheet
When Inflammation Persists
Chronic and granulomatous inflammation for NEET-PG: macrophages, epithelioid cells, Langhans giant cells, caseating vs non-caseating granulomas, and TB.
MedNext Academy | 3 min read
When Inflammation Persists
Chronic and granulomatous inflammation for NEET-PG: macrophages, epithelioid cells, Langhans giant cells, caseating vs non-caseating granulomas, and TB.
Chronic inflammation, its cellular players, and the specific pattern of granulomatous inflammation.
High-yield lines
- Chronic inflammation is characterised by infiltration with macrophages, lymphocytes, and plasma cells rather than neutrophils.
- Chronic inflammation features tissue destruction and attempts at repair by angiogenesis and fibrosis occurring together.
- The macrophage is the central cell of chronic inflammation and is activated by interferon-gamma from T cells.
- A granuloma is a focal collection of epithelioid macrophages, often with a rim of lymphocytes and giant cells.
- Caseating granulomas with central necrosis are typical of tuberculosis, while non-caseating granulomas suggest sarcoidosis.
- Langhans giant cells have peripheral horseshoe arrangement of nuclei and are seen in tuberculosis.
- Foreign body giant cells have haphazardly scattered nuclei and form around indigestible material.
- Epithelioid cells are activated macrophages with abundant pink cytoplasm resembling epithelial cells.
- Tuberculosis, leprosy, syphilis, fungal infection, sarcoidosis, and cat-scratch disease are important granulomatous conditions.
- Granuloma formation is a delayed-type (type IV) hypersensitivity reaction driven by T-helper 1 cells.
- Aschoff bodies are the granulomatous lesions of rheumatic heart disease containing Anitschkow cells.
- Persistent stimuli such as intracellular organisms, autoimmune disease, or foreign material drive chronic inflammation.
Mapped competency codes
- PA4.3
- PA4.4
Continue into the full chapter
This summary maps to PA4-inflammation.
Frequently Asked Questions
Which cells characterise chronic inflammation?
Macrophages, lymphocytes, and plasma cells, in contrast to the neutrophil-dominant infiltrate of acute inflammation.
What is a granuloma?
A focal aggregate of activated epithelioid macrophages, frequently surrounded by lymphocytes and containing multinucleated giant cells.
How do caseating and non-caseating granulomas differ in cause?
Caseating granulomas with central necrosis typically indicate tuberculosis, while non-caseating granulomas suggest sarcoidosis and some other conditions.
Which giant cell has a peripheral horseshoe arrangement of nuclei?
The Langhans giant cell, classically associated with tuberculous granulomas.
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