Granuloma

Granuloma call the limited accumulation of cells of young connecting fabric reminding by the form a small knot of the small size. Such educations appear at defeat of an organism by various infectious agents (tuberculosis, syphilis, rage, etc.) or collagenic diseases (for example, rheumatism). Besides, they develop in the place of hit of a foreign body in integuments and mucous.

Origin of granulomas

The etiology of granulomas is various. One of classifications of these educations is based on their origin:

• Noninfectious;
• Infectious;
• Unspecified genesis.

Noninfectious granulomas appear as a result of medicamentous influences (granulematozny hepatitises) or occupational dust diseases (a talcosis, a silicosis, asbestosis, etc.). They develop and around various foreign bodys.

Treatment of granulomas of infectious character (is closely connected with an origin at belly and a sapropyra, a tularemia, rage, syphilis, viral encephalitis, tuberculosis, etc.) as it is possible to get rid of the small centers of an inflammation only having destroyed the activator which caused them.

New growths at Horton's diseases belong to granulomas of the unspecified nature and Krone, a sarcoidosis, Wegener's granulomatosis.

Types of granulomas

In classification by morphological features allocate three main types of granulomas:

• Epithelioid and cellular, or epitelioidotsitoma;
• Macrophagic, or fagotsitoma;
• Giant-cell.

On a metabolic rate distinguish educations with the high and low level of a metabolism. The first appear under the influence of toxic agents (a leprosy, a tuberculosis mycobacterium, etc.) and are epithelioid and cellular small knots. The second arise under the influence of inert bodies and consist of colossal cells of foreign substances.

Even on one classification of a granuloma divide into two groups:

• Specific which morphology is characteristic of a specific infectious disease. At a research from the expanded cells it is possible to allocate the activator. Treat this group a ring-shaped, leprose, tubercular, skleromny, syphilitic granuloma;
• Nonspecific, not having any characteristic features. Arise as at infectious diseases (sypny and a typhoid, a leushmaniosis), and at noninfectious diseases (a silicosis, asbestosis).

It is possible to consider features of a disease on the example of two interesting kinds of granulomas: eosinophilic and piogenic.

Piogenic granulomas (botryomycomas)

Represent slightly raised formations of scarlet, brown or blue-black color. Growth of piogenic granulomas is caused by hypostasis of surrounding fabric and the accelerated development of a capillary network owing to injuries – cuts, grazes or pricks.

The disease develops promptly. Sometimes piogenic granulomas begin to bleed slightly as the skin closing them very thin. On unknown so far to the reasons similar educations can develop at pregnant women, but arise at adults up to 30 years and children more often.

Treat characteristic symptoms of a granuloma:

• Bright red, dark red, violet or brown-black color;
• Dense consistence;
• The shining, slightly bleeding surface;
• The size in the diameter up to 1,5 cm;
• Arrangement – on lips and gums, mucous a nose and fingers;
• Initial growth, and then insignificant reduction in sizes.

Usually piogenic granuloma disappears independently, but if it does not vanish, then it is recommended to make a biopsy and to make sure that the new growth is not malignant.

Effective treatment of a granuloma – surgical as conservative actions (use of ointments, brilliant green) do not yield a positive take. Education is excised, and its basis is scraped out special acute "spoon" then put stitches. Operation is performed under local anesthesia, the probability of a recurrence is minimum.

Eosinophilic granuloma (Taratynov's disease)

Represents the disease of not clear etiology which is characterized by emergence in bones of infiltrates which are rich with eosinophilic granulocytes. The disease meets seldom, children of preschool age have it, as a rule.

Eosinophilic granulomas are single or multiple centers in tubular and flat bones. Most often femoral, haunch, cranial bones and vertebrae are surprised.

Initial symptoms of a granuloma are the swelling and morbidity in the struck area. If the disease arises in skull bones, then the swelled up a little site becomes soft, and the edge of bone defect is probed as the crateriform thickening. At development of defect in long tubular bones the club-shaped thickening is palpated. Integuments over a swelling are usually not changed.

From other symptoms of a granuloma it is possible to note burning and an itch, and also hypersensitivity in places of defeat.

In general a condition of the patient satisfactory, some patients complain of headaches and unpleasant feelings at the movement.

The eosinophilic granuloma develops slowly, the course of a disease chronic, progresses in rare instances. Sometimes the disease accompanies the person for years, at the same time zones of defeat are already not so noticeable and change coloring, especially under the influence of ultra-violet radiation. At the extensive destructive centers formation of nearthroses and pathological changes are possible.

Apply the following methods of treatment of a granuloma:

• Roentgenotherapy of the centers of damage of a bone tissue;
• Surgical treatment (scraping, or curettage);
• Radiation therapy;
• Chemotherapy;
• Cryotherapy;
• Medicamentous therapy by drugs leukeranum, Vincristinum, Chlorbutinum, etc. (at acute manifestations).

As cases of spontaneous recovery are known, before use of the above described methods waiting tactics with careful observation of the patient in a hospital is used.