GRANULOMATOUS Dz—DANIEL TODD, MD

GRANULATION TISSUE (GT) = AN ATTEMPT AT HEALING

GRANULOMA = UNSUCCESSFUL GT

AN INFLAMMATORY PROCESS (BOTH ACUTE AND CHRONIC) WHICH DOES NOT REACH A CONCLUSION

USUALLY RESULTANT FROM A PERSISTENT INDIGESTIBLE IRRITANT

BASED ON A T-CELL MEDIATED IMMUNE RESPONSE

(MONOCYTIC) MODIFIED MACROPHAGES(PHAGOCYTES/HISTIOCYTES)—-EPITHELIOID T-CELLS—-FUSION—-LANGERHAN’S GIANT F.B. TYPE CELLS (INERT/IMMOBILE)—BECOME SURROUNDED BY FIBROBLASTIC PROLIFERATION AND ANGIOGENESIS

VARIABLE ETIOLOGIES:

INFXOUS

FUNGAL

HISTO, BLASTO, MUCOR, ASPERGILLIS, RHINOSPORIDIUM, COCCIDIO, CANDIDA

PARASITIC

LEISHMANIASIS, MYIASIS, TOXO

BACTERIAL

MBT, NMT, LEPROSY, CAT SCRATCH, ACTINO, SYPHILIS, RHINOSCLEROMA, BRUCELLOSIS, TULAREMIA, GRANULOMA INGUINALE

TRAUMATIC

POST INTUBATION GRANULOMA

PRIMARILY ON VOCAL PROCESSES OF ARYTENOIDS

FEMALE 3:1

MUSOSAL ABRASION–PERICHONDRITIS–SECONDARY INFXN—GT—GRANULOMA

PYOGENIC GRANULOMA

EOSINOPHILIC ULCER (GRANULOMA)—-RIGA-FEDE’S Dz/TRAUMATIC EOSINOPHILIC GRANULOMA/EOSINOPHILIC ULCER—-USUALLY ON THE TONGUE—BENIGN — SELF LIMITING

REPARATIVE GRANULOMA

REPARATIVE GRANULOMA (SCHUTNECHK)

POST STAPEDECTOMY

GRANULOMA IN POST MESO-TYMPANUM

SEVERE OTOLOGIC Sx

MUST RETURN TO OR IMMEDIATELY AND REMOVE

IDIOPATHIC

NECROTIZING SIALOMETAPLASIA

FOREIGN BODY

GOUT (PODAGRA), CHOLESTEROL GRANULOMA(IDIOPATHIC HEMOTYMPANUM), SILICOSIS, ASBESTOSIS, BERYLIOSIS, COCAINE INDUCED MIDLINE GRANULOMA, MYOSPHERULOSIS (LIPIOD GRANULOMA)–FROM PETROLEUM BASED OINT

NEOPLASMS

EXTRANODAL PERIPHERAL T-CELL LYMPHOMAS (EBV), HISTIOCYTOSIS X, ORBITAL PSEUDOTUMOR, POLYMORPHIC RETICULOSIS (LETHAL MIDLINE GRANULOMATOUS Dz, LOBAR CAPILLARY HEMANGIOMA (PYOGENIC GRANULOMA

SYSTEMIC Dz

AUTOIMMUNE/VASCULIDITIES

WG, SLE, SJOGRENS, SARCOID, CHURG-STRAUSS, GOODPASTEUR’S, POLYARTERITIS NODOSA, BEHCET’S