granulomatiske

Granulomatiske (granulomatous) is a term used in medicine to describe processes in which granulomas form. A granuloma is an organized collection of immune cells, typically macrophages that have transformed into epithelioid cells, often accompanied by multinucleated giant cells and surrounded by lymphocytes. Fibroblasts and connective tissue may be present as well. Granulomas arise as a persistent immune response to a antigen or irritant that is difficult to eradicate.

Morphologically, granulomas can be non-necrotizing or necrotizing. Non-necrotizing granulomas lack central tissue death, as seen in many cases of sarcoidosis, while necrotizing (caseating) granulomas show a central area of necrosis, characteristic of tuberculosis and certain fungal infections. The histological appearance can guide differential diagnosis but often requires correlation with clinical, microbiological, and radiological data.

Common causes include infectious and noninfectious etiologies. Infectious causes encompass Mycobacterium tuberculosis and other mycobacteria, histoplasma and other fungi, and certain bacteria that provoke granulomatous responses. Noninfectious causes include sarcoidosis, granulomatosis with polyangiitis, Crohn’s disease, foreign-body reactions to talc or silica, and exposure to inorganic dusts such as beryllium.

Diagnosis relies on tissue biopsy with histological examination, aided by special stains and cultures, molecular tests, and clinical/imaging context. Treatment targets the underlying cause: antimicrobials for infections, immunosuppressive or anti-inflammatory therapy for noninfectious inflammatory diseases, and removal of foreign material when feasible. Granulomatiske processes remain a key area in pathology and clinical medicine due to their broad differential and impact on organ function.