The morphology of tuberculous granulomas in bronchial biopsies

Zdravko Kosjerina Orcid logo ,
Zdravko Kosjerina
Vesna Kosjerina-Oštrić
Vesna Kosjerina-Oštrić

Published: 01.12.2012.

Biochemistry

Volume 29, Issue 4 (2013)

pp. 946-952;

https://doi.org/10.5937/matmed1304946k

Abstract

The granuloma is defined as a focal, chronic, mostly mononuclear inflammatory response to present irritants. The Material of the investigation included bronchobiopsy samples taken from 31 TB patients. The histological features of 53 tuberculous granulomas localized in the bronchial structures were determined in the study. The quantity, structure and distribution of the cellular and connective elements in the bronchial structures, as well as in the gra-nuloma, were determined by the quantitative stereome-tric method, using the numerical density as the stereolo-gical variable. The tuberculous granuloma, in the average size of 622x343 microns, was most frequently localized in the internal third of the lamina propria (34% of the ca-ses), at the average distance of 185 microns from the basal membrane. The central part of the granuloma was invaded by epithelioid and giant cells, macrophages, lymp-hocytes, plasma cells and fibroblasts, with the mean numerical density of 84151 mm-3. Lymphocytes were greatest in number, followed by epithelial cells, which were 2.5 times as few as lymphocytes. Giant cells, mostly Langhans in type, were registered in 66% of the granulomas. The mean numerical density of all cells in the peripheral part of the granuloma was 243964 mm-3. The peripheral part of the granuloma was predominantly infiltrated by lymp-hocytes, making 93% of all cellular elements. Caseous necrosis was registered in 13% of the granulomas, and acid resistant bacilli in 11% of the biopsy samples. The mean numerical density of all cells in the central part of the tuberculous granuloma was 84151 mm-3, with predominating lymphocytes and epithelioid cells. The mean numerical density of all cells in the peripheral part of the granulo-ma was 243964 mm-3, with predominating lymphocytes, making 93%. Caseous necrosis and acid-resistant bacilli were registered in every eighth granuloma.

Keywords

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