乾酪化

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/12 03:08:53」(JST)

wiki en

Caseous necrosis is a form of cell death in which the tissue maintains a cheese-like appearance.^[1] The dead tissue appears as a soft and white proteinaceous dead cell mass.

Causes

Frequently, caseous necrosis is encountered in the foci of tuberculous infections.^[2] It can also be caused by syphilis and certain fungi.

A similar appearance can be associated with histoplasmosis, cryptococcosis, and coccidioidomycosis.^[3]

Appearance

In caseous necrosis no histological architecture is preserved. On microscopic examination with H&E staining, it is characterized by acellular pink areas of necrosis surrounded by a granulomatous inflammatory process.

When the hilar lymph node for instance is infected with tuberculosis and leads to caseous necrosis, its gross appearance can be a cheesy tan to white, which is why this type of necrosis is often depicted as a combination of both coagulative and liquefactive necrosis.

However, in the lung, extensive caseous necrosis with confluent cheesy tan granulomas is typical. The tissue destruction is so extensive that there are areas of cavitation (also known as cystic spaces). See Ghon's complex.

Caseous necrosis in the lung
Caseous necrosis in the pleura
Caseous necrosis in the kidney

References

^ Robbins and Cotran: Pathologic Basis of Disease, 8th Ed. 2010. Pg. 16
^ Robbins and Cotran: Pathologic Basis of Disease, 8th Ed. 2010. Pg. 16
^ "Pulmonary Pathology". Retrieved 2008-11-21.

External links

Microscope images of caseous necrosis
Image of a hilar lymph node demonstrating caseous necrosis
Image of a caseating granuloma of tuberculosis in the adrenal gland

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 結核性腸炎 tuberculous enteritis
2. 肉芽腫性胃炎 granulomatous gastritis
3. HIV血清陰性患者における結核性胸水 tuberculous pleural effusions in hiv seronegative patients
4. 結核の微生物学および病因 microbiology and pathogenesis of tuberculosis
5. サルコイドーシスの皮膚症状 cutaneous manifestations of sarcoidosis

English Journal

Spontaneous choledochoduodenal fistula with tuberculous duodenal ulceration.

Karthikeyan V1, Sistla S2, Ram D, Ali S, Rajkumar N, Balasubramaniam G, Sanker M.Author information 1Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.2sarathsistla@hotmail.com.AbstractSpontaneous choledochoduodenal fistulas (CDFs) are rare. The most common aetiology is penetrating duodenal ulcers, observed in 80% of cases. Even in areas where acid peptic disease is common, tuberculosis should be considered as a cause, especially in developing countries like India, where tuberculosis is common. The management of CDF due to acid peptic disease is predominantly surgical while healing of tuberculous CDF has been reported with antitubercular treatment. A preoperative diagnosis of tuberculous CDF by endoscopic biopsy from the duodenal ulcer or image guided fine needle aspiration if abdominal lymph nodes are present can eliminate the need for surgery and achieve a cure with antitubercular treatment. The CDF in this case was due to caseation of periduodenal lymph nodes rupturing into the duodenum and the bile duct.
Annals of the Royal College of Surgeons of England.Ann R Coll Surg Engl.2014 Jan;96(1):104-5. doi: 10.1308/003588414X13824511649292.
Spontaneous choledochoduodenal fistulas (CDFs) are rare. The most common aetiology is penetrating duodenal ulcers, observed in 80% of cases. Even in areas where acid peptic disease is common, tuberculosis should be considered as a cause, especially in developing countries like India, where tuberculo
PMID 24417856

Characteristics of endobronchial tuberculosis patients with negative sputum acid-fast bacillus.

Sahin F, Yıldız P.Author information Department of Pulmonology, Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul 34760, Turkey.AbstractOBJECTIVE: Endobronchial tuberculosis (EBTB) is defined as a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence, with or without parenchymal involvement. In this study, clinical, radiological and bronchoscopic characteristics of cases diagnosed to have EBTB were evaluated.
Journal of thoracic disease.J Thorac Dis.2013 Dec;5(6):764-70. doi: 10.3978/j.issn.2072-1439.2013.12.15.
OBJECTIVE: Endobronchial tuberculosis (EBTB) is defined as a tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence, with or without parenchymal involvement. In this study, clinical, radiological and bronchoscopic characteristics of cases diagnosed to have E
PMID 24409353

Trehalose 6,6'-dimycolate - A coat to regulate tuberculosis immunopathogenesis.

Welsh KJ1, Hunter RL1, Actor JK2.Author information 1Department of Pathology, Medical School, University of Texas-Houston Medical School, Houston, Texas, USA.2Department of Pathology, Medical School, University of Texas-Houston Medical School, Houston, Texas, USA. Electronic address: Jeffrey.K.Actor@uth.tmc.edu.AbstractTuberculosis (TB) remains a significant public health burden worldwide. Treatment of this disease requires a minimum of six months and there is no vaccine available for the most common form of the disease. Increasing evidence suggests that the mycobacterial glycolipid trehalose 6,6' dimycolate (TDM; cord factor) plays a key role in the pathogenesis of TB disease. TDM protects the TB bacilli from macrophage-mediated killing, inhibits effective antigen presentation, and reduces the formation of protective T-cell responses. TDM promotes initiation of granuloma formation and likely plays a role in caseation. Furthermore, TDM may contribute to the development of post primary disease. Receptors for TDM were recently described and are expected to contribute to our knowledge of the molecular pathogenesis of TB disease. In this manner, understanding TDM may prove promising towards development of targeted TB therapeutics to limit clinical pathologies.
Tuberculosis (Edinburgh, Scotland).Tuberculosis (Edinb).2013 Dec;93 Suppl:S3-9. doi: 10.1016/S1472-9792(13)70003-9.
Tuberculosis (TB) remains a significant public health burden worldwide. Treatment of this disease requires a minimum of six months and there is no vaccine available for the most common form of the disease. Increasing evidence suggests that the mycobacterial glycolipid trehalose 6,6' dimycolate (TDM;
PMID 24388646

Japanese Journal

脾臓に限局し悪性疾患との鑑別に難渋したサルコイドーシス症の1例

田崎健太郎,大島郁也,有我隆光,吉村清司,篠藤浩一,岡崎靖史,森岡伸浩,佐塚哲太郎,尾崎正彦,角田幸雄
日本消化器外科学会雑誌 42(1), 61-66, 2009-01-01
症例は36歳の男性で,嘔気および腹満感を主訴に受診.腹部超音波検査で低エコー,腹部造影CTで低吸収域となる多発結節性病変を脾臓に認めた.血液生化学検査では異常値を認めず,s-IL2は324U/mlと正常範囲内であった.上部および下部消化管内視鏡検査を施行したが異常所見を認めず,また症状経過したこともあり経過観察となったが,fluorine-18 fluorodeoxyglucose-Positro …
NAID 110007024893

産褥期に急激な腹水貯留と血清CA125の上昇を認め悪性腫瘍と偽診された結核性腹膜炎の1症例

石野陽代,山口昌美,生田明子,江川真人,依岡寛和,中嶋達也,安田勝彦,神崎秀陽
産婦人科の進歩 56(1), 5-9, 2004
　結核性腹膜炎は，本邦結核患者の1%未満とされ，結核のなかでは比較的まれである．われわれは産褥期に悪性腫瘍と偽診された結核性腹膜炎を経験したので報告する．　症例は，正常経腟分娩後1ヵ月目の産褥検診にて腹水貯留と臍周辺部の腫瘤，血清CA125の異常高値を示した．胸部X線では肺結核を示唆する所見は得られず，腹水の塗抹鏡検，培養検査でも結核菌感染を示す所見は得られなかった．ガリウムシンチグラムにて臍周 …
NAID 130001223421

Related Pictures

Caseous necrosis - wikidoc Chronic inflammation - If damaging stimulus is of short duration & does not persist Pathology - MPPC at Ohio State University College of Medicine - StudyBlue Inflammation Histo - Medicine Foundations 2 with Hitchcock at Ohio State University Caseous necrosis - Wikipedia Caseous necrosis - Wikiwand