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Journal of Cutaneous Pathology Feb 2023Sarcoidosis is a systemic inflammatory disorder characterized by the formation of non-caseating granulomas. Cutaneous involvement of sarcoidosis is common and has a wide... (Review)
Review
Sarcoidosis is a systemic inflammatory disorder characterized by the formation of non-caseating granulomas. Cutaneous involvement of sarcoidosis is common and has a wide variety of clinical presentations. Herein, we present a case of cutaneous sarcoidosis mimicking pigmented purpuric dermatosis (PPD) in a 26-year-old female treated with topical tofacitinib cream and a literature review of all other reported cases of cutaneous sarcoidosis with PPD-like features.
Topics: Female; Humans; Adult; Pigmentation Disorders; Purpura; Sarcoidosis; Granuloma
PubMed: 36070081
DOI: 10.1111/cup.14326 -
International Immunology Mar 2024In sarcoidosis, granulomas develop in multiple organs including the liver and lungs. Although mechanistic target of rapamycin complex 1 (mTORC1) activation in...
In sarcoidosis, granulomas develop in multiple organs including the liver and lungs. Although mechanistic target of rapamycin complex 1 (mTORC1) activation in macrophages drives granuloma development in sarcoidosis by enhancing macrophage proliferation, little is known about the macrophage subsets that proliferate and mature into granuloma macrophages. Here, we show that aberrantly increased monocytopoiesis gives rise to granulomas in a sarcoidosis model, in which Tsc2, a negative regulator of mTORC1, is conditionally deleted in CSF1R-expressing macrophages (Tsc2csf1rΔ mice). In Tsc2csf1rΔ mice, common myeloid progenitors (CMPs), granulocyte-monocyte progenitors (GMPs), common monocyte progenitors / monocyte progenitors (cMoPs / MPs), inducible monocyte progenitors (iMoPs), and Ly6Cint CX3CR1low CD14- immature monocytes (iMOs), but not monocyte-dendritic cell progenitors (MDPs) and common dendritic cell progenitors (CDPs), accumulated and proliferated in the spleen. Consistent with this, monocytes, neutrophils, and neutrophil-like monocytes increased in the spleens of Tsc2csf1rΔ mice, whereas dendritic cells did not. The adoptive transfer of splenic iMOs into wild-type mice gave rise to granulomas in the liver and lungs. In these target organs, iMOs matured into Ly6Chi classical monocytes/macrophages (cMOs). Giant macrophages (gMAs) also accumulated in the liver and lungs, which were similar to granuloma macrophages in expression of cell surface markers such as MerTK and SLAMF7. Furthermore, the gMA-specific genes were expressed in human macrophages from sarcoidosis skin lesions. These results suggest that mTORC1 drives granuloma development by promoting the proliferation of monocyte/neutrophil progenitors and iMOs predominantly in the spleen, and that proliferating iMOs mature into cMOs and then gMAs to give rise to granuloma after migration into the liver and lungs in sarcoidosis.
Topics: Mice; Humans; Animals; Cell Differentiation; Macrophages; Monocytes; Sarcoidosis; Granuloma; Mechanistic Target of Rapamycin Complex 1
PubMed: 38147536
DOI: 10.1093/intimm/dxad054 -
Canadian Journal of Gastroenterology =... Sep 2007The epithelioid granuloma is a characteristic histological feature of Crohn's disease. In some pathological classification schemes, the criteria for a definite, probable...
BACKGROUND
The epithelioid granuloma is a characteristic histological feature of Crohn's disease. In some pathological classification schemes, the criteria for a definite, probable or possible diagnosis have been listed, with the epithelioid granuloma indicating definite Crohn's disease.
METHODS
In the present evaluation, 247 prospectively evaluated Crohn's disease patients (24.3%), from a consecutively accumulated population database of 1015 patients, were found to have an epithelioid granuloma. The recently devised Montreal classification for Crohn's disease was then applied to this granuloma-positive cohort of Crohn's disease patients to define age at diagnosis for men and women, disease site and disease behaviour.
RESULTS
The investigation showed that patients with Crohn's disease and granulomas were most often diagnosed early in the course of their disease, particularly women. Their disease was often extensive, with ileocolonic and upper gastrointestinal tract involvement. Finally, disease behaviour was most often complex, especially with penetrating disease complications.
CONCLUSION
Using homogeneous (ie, 'reagent-grade') patient cohorts defined by a recently devised classification method for Crohn's disease, the study demonstrated that an epithelioid granuloma may represent a histopathological marker for an early biological event in the etiopathogenesis of Crohn's disease, and this may have predictive significance with respect to the location and clinical behaviour of Crohn's disease.
Topics: Adolescent; Adult; Age Factors; Age of Onset; Crohn Disease; Databases, Factual; Disease Progression; Female; Follow-Up Studies; Gastrointestinal Tract; Granuloma; Humans; Male; Predictive Value of Tests; Prospective Studies; Sex Factors
PubMed: 17853953
DOI: 10.1155/2007/917649 -
BMJ Case Reports Feb 2022Ocular symptoms are a common reason for patients to present to the emergency department or to their primary care physician. Though often benign, these symptoms can also...
Ocular symptoms are a common reason for patients to present to the emergency department or to their primary care physician. Though often benign, these symptoms can also be an early manifestation of systemic disease. We report the case of a patient who presented to the emergency department with 1 week of rash followed by 2 days of fever, sore throat, chills, blurry vision and photophobia. His physical examination was notable for a desquamative rash over his tattoos, left-sided tonsillar exudate and pharyngeal oedema without lymphadenopathy. Biopsy of his tattoos revealed subepithelial non-caseating granulomas, confirming the diagnosis of tattoo granulomas with uveitis. The patient was started on corticosteroids and methotrexate and responded well to treatment. This case emphasises the importance of recognising ocular symptoms that are indicative of systemic disease and require further evaluation.
Topics: Biopsy; Foreign-Body Reaction; Granuloma; Humans; Tattooing; Uveitis
PubMed: 35131770
DOI: 10.1136/bcr-2021-244196 -
The European Respiratory Journal Apr 1994Granuloma is a feature of many chronic interstitial lung diseases, and may serve as a focus for subsequent fibrosis. Granulomas are composed of structured masses of... (Review)
Review
Granuloma is a feature of many chronic interstitial lung diseases, and may serve as a focus for subsequent fibrosis. Granulomas are composed of structured masses of cells of the macrophage lineage, which adopt an epithelioid aspect, interspersed with lymphocytes. They are formed around local centres of irritation. During their resolution, fibroblasts congregate around the structures and may penetrate the interior. In many cases, granulomas can disappear without leaving lasting traces. However, especially when damage has occurred to the surrounding tissue, permanent scarring and fibrosis may occur. Both types of cell present in the granuloma are capable of secreting a number of factors influencing the accumulation and proliferation of fibroblasts, both positively and negatively. The possible roles played by the different factors and, especially, interactions between them are discussed in the light of fibrosis formation. Possible therapeutic interventions are summarized.
Topics: Cytokines; Fibroblasts; Granuloma; Humans; Lung; Lung Diseases, Interstitial; Macrophages; Pulmonary Fibrosis
PubMed: 8005262
DOI: 10.1183/09031936.94.07040779 -
Treatment of post-intubation laryngeal granulomas: systematic review and proportional meta-analysis.Brazilian Journal of Otorhinolaryngology 2018Laryngeal granulomas post intubation are benign but recurrent lesions. There is no consensus for its treatment. (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Laryngeal granulomas post intubation are benign but recurrent lesions. There is no consensus for its treatment.
OBJECTIVE
To describe the effectiveness of different treatment modalities for primary or recurrent laryngeal granulomas resulting from endotracheal intubation.
METHODS
Systematic review and proportional meta-analysis. Eligibility criteria - experimental or observational studies with at least five subjects. Outcomes studied - granuloma resolution, recurrence, and time for resolution. Databases used - Pubmed, Embase, Lilacs, and Cochrane. The Stats Direct 3.0.121 program was used.
RESULTS
Six studies were selected, with 85 patients. The treatments registered were: antireflux therapy, speech therapy, anti-inflammatory drugs, steroids, antibiotics, zinc sulfate and surgery. 85 patients from six studies had primary treatment: surgery±associations (41 patients), resolution chance 75% (95% CI: 0.3-100%, I=90%), absolute relapse risk 25% (95% CI: 0.2-71%); medical treatment (44 patients), resolution chance 86% (95% CI: 67-97%); and absolute relapse risk 14% (95% CI: 3-33%). There was no significant difference between groups. Three studies, encompassing 19 patients, analyzed secondary treatment (failure or recurrence after primary treatment); three subjects presented new recurrence. The time needed to resolve the lesions varied from immediate, after surgery, to 23 months, for inhaled steroid.
CONCLUSION
There is no evidence of high quality that proves the efficacy of any treatment for laryngeal granulomas resulting from endotracheal intubation.
Topics: Combined Modality Therapy; Granuloma, Laryngeal; Humans; Intubation, Intratracheal; Recurrence; Time Factors; Treatment Outcome
PubMed: 29699879
DOI: 10.1016/j.bjorl.2018.03.003 -
Ear, Nose, & Throat Journal Dec 2023Cholesterol granulomas are rare cystic inflammatory lesions characterized by the formation of cholesterol crystals. They are the most prevalent lesions of the petrous...
Cholesterol granulomas are rare cystic inflammatory lesions characterized by the formation of cholesterol crystals. They are the most prevalent lesions of the petrous apex and when symptomatic, hearing loss, vertigo, tinnitus, headache, and facial pathology can be present. Surgical management is recommended in symptomatic patients. There are different surgical approaches to cholesterol granulomas. The aim of this article is to present and describe an endoscopic endonasal nasopharyngeal approach to a cholesterol granuloma and explain the advantages and disadvantages.
Topics: Humans; Petrous Bone; Endoscopy; Cholesterol; Granuloma; Hearing Loss; Granuloma, Foreign-Body
PubMed: 34233514
DOI: 10.1177/01455613211028074 -
Ear, Nose, & Throat Journal Sep 2018
Topics: Aged; Cysts; Dysphonia; Female; Granuloma; Humans; Laryngoscopy; Postoperative Complications
PubMed: 30273424
DOI: 10.1177/014556131809700914 -
Immunology Letters May 2010The presence of dendritic cells (DCs) in mycobacterium-containing granulomas, as well as in other granuloma-inducing diseases, is beginning to be appreciated. This... (Review)
Review
The presence of dendritic cells (DCs) in mycobacterium-containing granulomas, as well as in other granuloma-inducing diseases, is beginning to be appreciated. This review will summarize what is known about DCs with regards to the granuloma and discuss the potential roles DCs may be playing during mycobacterial infection. Potential functions may include mycobacterial dissemination from lesions or sampling of granuloma-containing mycobacterial antigens and migration to the draining lymph nodes to maintain continuous T cell priming. Additionally, the review will discuss the potential outcomes of DC-T cell cross-talk within the granuloma and whether it results in boosting the effector functions of newly arrived T cells or anergizing systemic T cells locally. Understanding the DCs complex and changing role during this critical stage may help explain how latency is achieved and maintained. Such knowledge might also lead to improved vaccination strategies.
Topics: Animals; Dendritic Cells; Granuloma; Humans; Mycobacterium; Receptor Cross-Talk
PubMed: 20005900
DOI: 10.1016/j.imlet.2009.12.009 -
The American Journal of Tropical... Jun 2020Most schistosomiasis japonica cerebral granulomas reported in the literature have been single and located in the cerebellum, and multiple lesions located in the cerebral... (Review)
Review
Most schistosomiasis japonica cerebral granulomas reported in the literature have been single and located in the cerebellum, and multiple lesions located in the cerebral hemisphere are uncommon and often misdiagnosed as metastases or gliomas. We describe two rare cases of multiple schistosomiasis japonica cerebral granulomas. Laboratory examinations and cerebrospinal fluid were normal. Parasite eggs were not detected in the stool. No positive findings were detected in the abdominal ultrasonography or chest radiography. Magnetic resonance revealed two intensive patchy lesions in the cerebral hemisphere and surrounded by a large area of edema in both of our patients. Both were misdiagnosed as glioma or metastatic carcinoma before operation. Pathological examination confirmed that the diagnosis was schistosomiasis japonica cerebral granuloma. Praziquantel and dexamethasone were administered. Both patients are alive, symptom-free, and without evidence of recurrence. Combining our date with other literature reports, we summarize the possible mechanism, reasons for misdiagnosis, radiological characteristics, surgical treatment, and postoperative management of schistosomiasis japonica cerebral granuloma, which can be used for clinical reference and to improve our knowledge of schistosomiasis japonica cerebral granuloma.
Topics: Aged; Anthelmintics; Anti-Inflammatory Agents; Brain Diseases; Granuloma; Humans; Male; Middle Aged; Schistosomiasis japonica
PubMed: 32274982
DOI: 10.4269/ajtmh.19-0797