Granulomatous Reaction


The granulomatous reaction is a distinctive pattern of chronic inflammation characterized by nodular aggregation of inflammatory cells, predominantly activated macrophages, which often are transformed into epithelium-like (epithelioid) cells. Other cellular components that may be present in granulomas are lymphocytes, plasma cells, fibroblasts and multinucleate giant cells of Langhans or foreign body type. Granulomas are found in approximately 2.5–9% of all liver biopsies (see Section XIX).

Granuloma Types

There are two types of granulomas, which differ in their pathogenesis
  • Foreign body granulomas and

  • Immune granulomas

Foreign Body Granulomas

Foreign body granulomas are elicited by relatively inert foreign material, such as talc, starch, silicone or fat. Lipo- and mineral oil granulomas also are among foreign body granulomas (see below).

Immune Granulomas

Immune granulomas form in the context of a cellmediated immune response elicited by insoluble antigens, typically microbes. During...


Foreign Body Granuloma Granulomatous Hepatitis Epithelioid Granuloma Sarcoid Granuloma Foreign Body Type 
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Copyright information

© Springer-Verlag Berlin Heidelberg 2010

Authors and Affiliations

  1. 1.Chair, Department of Medicine II, Klinikum OffenbachGoethe University Frankfurt/MainOffenbachGermany
  2. 2.Department of Medicine, Division of Liver DiseasesMount Sinai School of MedicineNew YorkUSA
  3. 3.University Professor of Pathology, Institute of PathologyUniversity of HeidelbergHeidelbergGermany

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