In necrotizing lymphadenitis of tuberculosis, histoplasmosis, leprosy, and cat-scratch disease, there is proliferation of epithelioid histiocytes
with granuloma formation, as well as scattered giant cells.
Biopsy of the pinna and oral cavity revealed diffuse, mixed inflammatory infiltrate and numerous epithelioid histiocytes
containing small, circular yeast cells compatible with Histoplasma capsulatum (figure 2).
In the histopathological examination of the prepared sections, we found lobule-restricted, non-caseous granulomas involving lymphocytes, plasma cells, epithelioid histiocytes
and multinuclear giant cells and neutrophil assemblages in the middle; and neoplastic epithelial cell proliferation in 4 different foci, the largest being 0.7x0.4 cm in diameter, limited to the ductal lobular system.
Rheumatoid pulmonary nodules contained central necrosis surrounded by epithelioid histiocytes
, lymphocytes, plasma cells, and proliferating fibroblasts.
Foci of acute and granulomatous inflammation were appreciated (Figure 5) along with epithelioid histiocytes
and multinucleated giant cells (Figure 6).
Therefore, she underwent a dural biopsy from the thickened dura, which revealed large areas of caseous necrosis surrounded by epithelioid histiocytes
and lymphoid cells with a few isolated giant cells in the adjacent vicinity (Figure 2).
The characteristic histological feature of sarcoidosis is non-caseating granulomas consisting of epithelioid histiocytes
Pathological examination revealed granuloma structures with caseous necrosis composed of epithelioid histiocytes
. The diagnosis of primary tuberculosis of the sternoclavicular joint was made histologically.
(a) Histological appearance of tuberculous granuloma surrounded by palisaded epithelioid histiocytes
(broad arrow) with central caseous necrosis (long arrow), (b) magnified histological picture showing a Langhans giant cell (arrow), and (c) Langhans giant cell (arrow) with ZN staining.
Histopathological findings include a central area of coagulative necrosis, obliterative endarteritis, plasma cells, and epithelioid histiocytes
. Papillitis and gummas, which were present in our patient, are manifestations of tertiary syphilis.
Microscopic examination of the removed lung showed areas of fibrinous and organizing pneumonia and abscesses palisaded by epithelioid histiocytes
and giant cells.
Histopathologically, lipogranuloma is characterized by multiple fat vacuoles surrounded by granulomatous tissue composed of multinucleated giant cells, epithelioid histiocytes
, and fibrosis.