The morphology of tuberculous granulomas in bronchial biopsies

Abstract

The granuloma is defined as a focal, chrome, mostly mononuclear inflammatory response to present irritants. The Material of the investigation included bronchobiopsy samples taken from31TB patients. The histological featu­res of 53 tuberculous granulomas localized m 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 granuloma, were determined by the quantitative stereometric method, using the numerical density as the stereological 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 ca­ses), 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, lymphocytes, 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 lymphocytes, making 93%of all cellular elements. Caseousnecrosis 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 granuloma was 243964 mm-3, with predominating lymphocytes. making 93%. Caseous necrosis and acid-resistant bacilli were registered in every eighth granuloma.