【INF】乾酪性(壞死性)肉芽腫與非乾酪性肉芽腫－小節的醫學筆記

胸部X光上看到Nodule時候，醫師會懷疑TB結合分枝桿菌、肺結核。小弟2019年時就有因上肺葉有nodule而驗過TB，後來是陰性。

乾酪性肉芽腫是TB的典型病理特徵，然後看到乾酪性壞死就會想到非乾酪性非壞死性肉芽腫是什麼，故整理一下。

肉芽腫形成的過程是慢性的，過程中有非免疫細胞fibroblasts參與形成epitheloid cells；免疫細胞有Th cells和Macrophage參與。

1. Non-caseating granuloma is a granuloma that is not associated with necrotic changes. The majority of cases are of non-infectious origin. Causes include sarcoidosis, hypersensitivity pneumonitis, drug reactions, and Crohn disease. 乾酪性肉芽腫大多是感染引起。非乾酪性壞死多是非感染引起，例如類肉瘤、過敏性肺炎、藥物熱、Crohn disease。

2. NONCASEATING GRANULOMA (非乾酪狀肉芽腫)
Sarcoidosis is characterized by noncaseating granulomas. These are different than the caseating granulomas produced by other diseases, especially tuberculosis. Caseous necrosis is destruction of cells which are converted to amorphous greyish(無定形灰色的) debris located centrally in granulomas.
乾酪性壞死性肉芽腫大多是結合分枝桿菌引起，在壞死肉芽腫中央，有灰色物質沉積。