These tubercles are often full of caseating necrosis
. Once again, this necrosis often leads to ulceration of the skin and formation of sinus tracts.
Histopathological study of the sections revealed epitheloid granuloma with multinucleate giant cells with large areas of caseating necrosis
suggestive of tuberculosis.
Tuberculous granulomatous prostatitis showed areas of caseating necrosis
with granulomas and Langhan's type giant cells.
Pathology (Figures 7 and 8) showed the presence of numerous granulomas, most with caseating necrosis
and was consistent with Sporothrix infection.
Grossly, the epididymis was enlarged (6.0 x 1.7 x 1.5 cm; Figure 2), with caseating necrosis
and miliary deposits within the testicle and epididymis (Figure 3).
The biopsy showed a granulomatous inflammatory reaction, with small- and medium-sized vessels vasculitis and a hemorrhagic and necrotic-background and without the characteristic features of caseating necrosis
. The diagnosis of limited GPA was considered and patient was referred to Rheumatology Unit.
On histopathological examination, epitheloid granulomas with caseating necrosis
were seen which was suggestive of tuberculosis (figure 2).
Histopathology from gallbladder shows granuloma comprising of caseating necrosis
, epitheloid cells, giant cells, lymphocytes and fibroblast.
Sections from the growth showed granuloma formation along with areas of caseating necrosis
and Langhans type giant cells, suggestive of tuberculosis (Fig.
Pathologic examination of excised lymph nodes of the bilateral inguinal area showed reactive lymphoid proliferation and granulomatous inflammation with multinucleate giant cell formation, suggestive of mycobacterial disease; however, there was no evidence of caseating necrosis
or acid-fast bacilli.
The histopathology showed features of epitheloid granuloma, caseating necrosis
surrounded by Langhans giant cells, (Fig.
These tubercles show characteristic amorphous caseating necrosis
which may rupture into surrounding structures, such as the airway and blood stream, causing endobronchial or hematogenous dissemination.