Granuloma

definition

The term "granuloma" comes from the Latin and means "nodule" when translated. This word origin explains the frequent use of the word, even if, strictly speaking, it is not always correct. Because originally the granuloma only describes an inflammatory reaction in our body.

Under the microscope - invisible to the naked eye - cells react to a long-lasting inflammatory stimulus that cannot be completely eliminated. "Scavenger cells" of the immune system, called phagocytes, try the damaging substances, e.g. Kill bacteria, in vain. As a reaction, the neighboring tissue is remodeled. The resulting granulomas can often be seen as "nodules" with the naked eye.

Causes of a Granuloma

The causes of granulomas are very diverse and can affect almost any part of the body.

Common causes are:

• tuberculosis
• Sarcoid
• arthritis
• Crohn's disease
• Operations
• foreign body
• Autoimmune diseases
• syphilis
• Lyme disease

In some cases, the occurrence of a granuloma cannot be clearly identified. This includes the "granuloma annulare" of the skin. Young people in particular suffer from the painless, circular, raised lump on the skin. Although a connection with diabetes mellitus ("diabetes") and the harmless skin condition is suspected, this has not yet been sufficiently proven.

Symptoms of a granuloma

The symptoms are as varied as the appearance of granulomas. The decisive factors are certainly both the location and the causative disease of the granuloma. Possible comorbidities and the general health of the person concerned also play a role.

Some granulomas, such as the aforementioned granuloma annulare of the skin, are completely harmless and do not cause any symptoms.

In contrast, granulomas in the lungs, e.g. triggered by tuberculosis, lead to serious complaints. These include a bloody cough, shortness of breath and severe weight loss.

Granulomas in the area of ​​an operation scar, so-called "thread granulomas", can cause pain and a feeling of pressure in the affected area.

Pregnant women occasionally suffer from a so-called "pyogenic granuloma". It is believed that the changed hormone balance leads to the development of benign, blood sponge-like skin changes. Apart from the cosmetically disturbing aspect, the pyogenic granuloma does not cause any symptoms. Fortunately, it resolves on its own after the pregnancy is over.

diagnosis

Since granulomas can be observed in many diseases, the diagnosis is not always easy to make.

These are to be distinguished Granulomas of the skin, such as. Granuloma annulare or foreign body granules. You can often ask your doctor via "Eye diagnosis“Are identified and rarely require further diagnostic tools.

At Granulomas of the internal organs however, will often further steps to clarify the diagnosis initiated.

The first step towards diagnosis is the questioning of the patient. By describing previous complaints, the doctor can make initial assumptions. The appearance of a "nodule" in a fresh operation scar can be a major factor.

During the subsequent physical examination, the overall condition of the person concerned is recorded. If e.g. If a granuloma of the lungs is suspected, the stethoscope is used to listen to the organ.

In addition to the physical examination, imaging of the affected organ is very often done. Any existing granulomas can usually be discovered with X-ray, MRI or CT examinations. Final assurance however only delivers one Examination of tissue samples through the microscope. Characteristic signs of a granuloma can be clearly identified, classified and assigned to the corresponding disease.

Correct therapy for granuloma

It goes without saying that there is no standard therapy for granuloma. It is based on the underlying disease and can in principle take any form.

Surgical procedures as well as drug therapy are important pillars.

Some granulomas, especially "skin nodules", often only represent an aesthetic problem and do not require treatment. However, if those affected suffer from the skin appearance, therapy can also be provided here. Cold therapy, also called "kyrotherapy", can e.g. provide relief for granuloma annular. Various ointments, such as cortisone-containing preparations are used.

Other granulomas, e.g. Large foreign body granulomas in the former operating area can make a new surgical intervention indispensable.

Tuberculosis granulomas of the lungs, on the other hand, must be treated with strict, complicated and sometimes very protracted antibiotic therapy. Even the first suspicion of the sometimes highly contagious disease is enough to initiate therapy!
Please also read our article on this Therapy for tuberculosis

Granuloma after surgery

In the case of a postoperative granuloma, our organism reacts with one Defense reaction to foreign material. For example, the thread material of a surgical wound is "encapsulated" and a painful, lump-like swelling occurs. In this context one speaks of a foreign body or thread granuloma. Often disappear the uncomfortable nodules return after a few weeks by itselfso that no therapy is necessary. However, if the pain is severe or there is a risk of inflammation, surgical removal of the granuloma may be necessary.

Granuloma in the lungs

There are always granulomas in the lungs highly suspect for a serious illness of the organ. In this context, there are basically two possible causative diseases: tuberculosis or sarcoid.

tuberculosis, also known as "consumption", is a bacterially transmitted disease. A course with slight fever, unwanted Weight loss, Night sweats and persistent cough with blood. An X-ray examination of the lungs shows the typical granulomas in the lungs. Because tuberculosis very contagious and can be fatal if left untreated, it is imperative that affected persons be isolated. In this way, the risk of infection can be minimized. In the western world, the disease can usually be cured with the administration of several antibiotics over a period of up to seven months. Through continuously improved hygienic conditions and medical progress, tuberculosis has been almost completely contained in our latitudes. In many developing countries, but also in countries of the former Soviet Union, the disease still plays a very important role!

In contrast, sarcoid is not a contagious disease. For a previously unexplained cause, affected granulomas develop throughout the body, but mainly in the lungs. Cough, fatigue, joint pain, fever, skin symptoms or swelling of the lymph nodes are just a few of the symptoms of "chameleon-like sarcoid".

Please also read our topic on this Signs of tuberculosis

Granuloma on the navel

In particular newborn children are prone to having granuloma of the belly button. The remaining umbilical cord should fall off by itself within the first few days of life.

However, if the navel e.g. If urine from the diaper becomes moist, the risk of umbilical granuloma increases, also popularly known as "wild meat". With this nodular growth, the Around the navel in certain circumstances red, overheated and swollen be. Affected parents should consult their pediatrician to prevent possible spread of the inflammation. Local antibiotic ointments can quickly remedy the situation.

Granuloma on the finger

Small, ring-shaped and raised nodules on the finger can be a so-called Granuloma annulare represent. The harmless papules usually do not itch or hurt and are particularly likely to be found on the fingers and the back of the hand and foot. Most of all are Children and young adults affected.

In the most cases disappear the small granulomas again by itself and do not have to be treated. Occasionally, an attempt with cold therapy or cortisone ointment can be performed. However, surgical removal is not common.

Granuloma on the tooth

Our teeth are firmly anchored in the jawbone with their strong roots. If the tip of the root becomes inflamed, a granuloma of the tooth can develop. Bacteria often get through damage to the tooth, such as Tooth decay, towards the tip of the root. There the body reacts with the defense mechanisms already described, so that small nodules or granulomas arise.They often go unnoticed for a long time and only lead with advanced size to symptoms. Those affected then suffer from increased Sensitivity to pain, Feeling of pressure, throbbing pain up to Radiation of pain in the entire head area.

Often a root canal treatment is enough to remove the granuloma on the tooth. In some cases, however, your dentist may have to resort to apicectomy.

Granuloma on the eye

In rare cases, a granuloma can be observed in the eye. Due to their unfavorable location, they can seriously disturb the eyesight of those affected, so that granulomas in the eye area usually have a small operation removed. Occasionally they can be mistaken for barley grains by those affected, but the ophthalmologist should be able to distinguish them well.

Very often these are "pyogenic granulomas". They belong to the group of blood sponges and are completely benign. Granulomas of the conjunctiva or cornea are particularly unpleasant, but very rare.