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.
