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What on earth is caseous granulomatous inflammation?
Jan 21, 2002

What is caseous granulomatous inflammation?

Response from Dr. Dezube

Of course, I'd love to know in what context you came across this term.

First let me deal with the second part of the above expression-- "granulomatous inflammation". Granulomatous inflammation is a type of CHRONIC (of a long standing nature) inflammation seen by the pathologists when they look under the microscope. These pathologists see small collections of inflammatory cells. Such a finding is not that uncommon in HIV'ers. Pathologists can see granulomatous inflammation in a large variety of conditions, many of which afflict HIV'ers. Such conditions include such infections as tuberculosis, certain fungal infections, syphilis, mycobacterium avium complex (also known as MAI or MAC), cat-scratch fever, actinomycosis and so on. Certain types of lymphomas can also cause a granulomatous inflammation. Often the cause is unknown.

Now let's deal with the first word of the above expression-- caseous. Caseous comes from the word for cheesy. Sometimes when a pathologist looks at material taken from a patient, it is soft, easily breakable, and whitish-gray resembling clumped cheese. The medical word for this appearance is caseous.

So caseous granulomatous inflammation is something that the pathologists would use to describe tissue which has elements of chronic inflammation and which looks cheesy. Such a condition is most often seen in tuberculosis and tuberculosis-like diseases. However, such a condition can also be seen in many other conditions listed above. So, a finding of caseous granulomatous inflammation is a hint that something else is going on in the patient's body.

Hope this long-winded answer helps. It's been a long time since my days in pathology in medical school (over 20 years ago).


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