1. Tuberculous Lymphadenitis (15)
Granuloma
Tuberculous Lymphadenitis (15)
Tuberculous
Lymphadenitis
Epithelioid granuloma
Langhan’s giant cell
Caseous necrosis
T.B. of
the Lung
Sarcoidosis
Rhinoscleroma
Fungal
Granuloma
Nodal tissue
Extensive caseation

2. Tuberculous Lymphadenitis (15)
Granuloma
Tuberculous Lymphadenitis (15)
Section in a lymph node showing:
Effacement of the normal lymph node architecture and replacement by multiple confleunt (fused) epithelioid granulomas.
The granulomas are made up of epithelioid cells, multinucleated Langhan’s giant cells and a mantle of lymphocytes with central areas of pink homogenous structureless caseous necrosis.
Langhan’s cells show peripheral horse shoe arrangement of the nuclei.

3. Tuberculosis of the lung (16)
Granuloma
Tuberculosis of the lung (16)
Tuberculous
Lymphadenitis
Central caseation
T.B. of
the Lung
Sarcoidosis
Rhinoscleroma
Tubercle
Fungal
Granuloma
Langhan’s giant cell

4. Tuberculous of the lung (16)
Granuloma
Tuberculous of the lung (16)
Section in lung showing
Multiple scattered rounded tubercles
formed of:
-Epitheliod cells
-Lymphocytes
-Langhan’s giant cells
With little or no caseation
The intervening lung tissue shows compensatory emphysema.

5. Granuloma Sarcoidosis in lymph node (17)
Tuberculous
Lymphadenitis
Giant cell with Schaumann body
Langhan’s giant cell
T.B. of
the Lung
Sarcoidosis
Rhinoscleroma
Giant cell with Asteroid body
Fungal
Granuloma
Multiple epithelioid granulomas

6. Sarcoidosis of Lymph Node (17)
Granuloma
Sarcoidosis of Lymph Node (17)
Section in a lymph node showing
- Effacement of normal lymph nodal architecture and replacement by multiple discrete epithelioid non caseating granulomas, made up of epithelioid cells and multinucleated giant cells with a mantle of lymphocytes and some fibroblastic proliferation.
-The epithelioid cells are oval or rounded with faint eosinophilic cytoplasm and central or eccentric vesicular nuclei and ill defined borders.
-The langhan’s cells show peripheral horse shoe arrangement of the nuclei.
-Schaumann bodies and asteroids bodies may be present.

7. Granuloma Rhinoscleroma (18) Squamous epithelium Russel body
Tuberculous
Lymphadenitis
Squamous epithelium
Russel body
T.B. of
the Lung
Sarcoidosis
Rhinoscleroma
Fungal
Granuloma
Mickulicz cell

8. Granuloma Rhinoscleroma (18) Section in the nasal mucosa showing
Hyperplastic thickened stratified squamous epithelium.
The subepithelial tissue is formed of vascular connective tissue which is densely infiltrated by chronic inflammatory cells mainly histiocytes and plasma cells together with lymphocytes and fibroblasts.
There are two characteristic cells:
Mickulicz cells: large vacuolated with central or eccentric small dark nuclei
Russel bodies: oval eosinophilic homogenous structures.

9. Polymorphs and pus cells
Granuloma
Fungal Granuloma (6)
Tuberculous
Lymphadenitis
Polymorphs and pus cells
skin
T.B. of
the Lung
Sarcoidosis
Colonies of fungus
Rhinoscleroma
Fungal
Granuloma

10. Granuloma Fungal Granuloma (6) Section in the skin showing:
Multiple intradermal suppurative granulomas.
The central parts of the granulomas show pinkish colonies of a fungus surrounded by polymorphs and pus cells .
The peripheral parts of the granulomas show histiocytes, lymphocytes and fibroblasts .