caseøs

Caseös is a descriptive term used in pathology to indicate tissue with a cheese-like, crumbly appearance characteristic of caseous necrosis. The word stems from Latin caseus, meaning cheese, and is employed in some European medical texts to convey the distinctive texture and appearance of this form of cell death.

Macroscopic and microscopic features define caseös tissue. Macroscopically, affected areas are pale to white-yellow, soft, and friable, often appearing “crumbly.” Microscopically, there is a central area of acellular, eosinophilic necrosis surrounded by a granulomatous inflammatory response that typically includes epithelioid cells and multinucleated giant cells. The surrounding rim may show varying degrees of lymphocytes and fibroblasts, reflecting a chronic process.

Caseös necrosis is most classically associated with granulomatous diseases, most notably Mycobacterium tuberculosis infections. It can also be observed in certain fungal infections (such as Histoplasma) and in other chronic inflammatory conditions that produce granulomas. The presence of caseös necrosis can aid in differential diagnosis, helping to distinguish granulomatous processes from other forms of necrosis.

Diagnosis relies on histopathological examination of biopsy or resection specimens, often complemented by special stains and microbiological tests to identify infectious causes (for example, Ziehl-Neelsen staining for mycobacteria or fungal stains). Management focuses on treating the underlying disease, such as anti-tuberculous therapy for tuberculosis or appropriate antifungal therapy for fungal etiologies.

See also: caseous necrosis, granulomatous inflammation, tuberculosis, histoplasmosis.