Histologic changes: The following two images show another feature of the granulomatous inflammation. At low power, two similar, ill-defined lesions are present (arrows). The one at the left is shown at higher magnification below.

What type of cell is present at the edge of this lesion?

What type of cell is present at the center?

What are these lesions called?

What special stains should be done?

Answer

Clinical summary Image 3

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Answer:

The cells at the edge are epithelioid histiocytes and multinucleated giant cells. Centrally, PMNs predominate. The epithelioid cells are palisaded; that is, they are lined up with nuclei perpendicular to the edge. These lesions are called microabscesses.

Cultures and special stains for acid fast organisms and fungi should be done on all tissue that shows granulomatosis and/or microabscesses.

Clinical summary Image 3

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