Necrotizing granuloma

An inflammatory lesion characterized by central coagulative or caseous necrosis surrounded by epithelioid histiocytes, multinucleated giant cells, and lymphocytes, formed as an immune response attempting to contain persistent inflammatory stimuli or infectious agents.

Causes

• Infectious causes

  • Tuberculosis

  • Histoplasmosis

  • Aspergillosis

  • Blastomycosis

  • Cat-scratch disease (Bartonella henselae)

  • Tularemia

  • Nontuberculous mycobacterial infections

• Autoimmune and inflammatory causes

  • Granulomatosis with polyangiitis (Wegener granulomatosis)

  • Rheumatoid arthritis

  • Other chronic granulomatous inflammatory disorders

• Lymphoma

• Foreign body reactions