Practical

The Practical of Chronic Inflammation

chronic inflammation due to hypersensitivity reaction: Nasal mass with edematous stroma with chronic inflammatory cell infiltrate ( mainly eosinophils) covered by ciliated columnar epitheliumallergic nasal polyp


Certain etiologic agents such as viruses are more likely to lead to chronic inflammation,. Note also that the inflammatory infiltrates of chronic inflammation are more likely to be interstitial (within tissues) rather than exudative (above surfaces or in spaces) like acute inflammation


chronic inflammation of the bronchi has led to dilation and scarring with increased tan to white collagenous tissue


An abscess may have elements of chronic inflammation if it persists for some time. Seen here in the right middle lung lobe have such a chronic abscess


The end result of inflammation can be scarring. Here, the alveolar walls are thickened and filled with pink collagen following an autoimmune disease lasting for decades.


The inhaled silica persists indefinitely and produces an inflammatory reaction that is marked by prominent fibrosis. Dense pink collagen is seen in the center of the nodule.



Grossly, a granuloma tends to be a focal lesion. Seen here in a hilar lymp node with a granuloma. Granuloma with caseous necrosis (cheesy- like material)

microscopic section of lung in which there are scattered granulomas in the parenchyma

Here are two pulmonary granulomas. Granulomatous inflammation typically consists of epithelioid macrophages, giant cells, lymphocytes, plasma cells, and fibroblasts. There may be some neutrophils.


Here is a foreign body type giant cell at the upper left of center adjacent to a segment of vegetable material aspirated into the lung. Such foreign body giant cells have nuclei scattered haphazardly about the cell.


Two foreign body giant cells are seen just to the right of center where there is a bluish strand of suture material from a previous operation.

Foreign body granuloma around dead calcified parasite in the lung

Seen here are two Langhans type giant cells in which the nuclei are lined up around the periphery of the cell. Additional pink epithelioid macrophages compose most of the rest of the granuloma.



Granuloma composed of epithelioid cells surrounded by lymphocyte rim with langhans type giant cell. No necrosis is seen in this granuloma


Langhans type giant cell at high power view is composed of cytoplasmic fusion of many epithelioid cells with their nuclei arranged at the periphery of the cell

This is a caseating granuloma. Epithelioid cells surround a central area of necrosis that appears irregular, amorphous, and pink.

Granuloma with central necrosis which appears as eosinophilic finely granular material, such granuloma is usually due to T.B.