Granuloma is a pattern of chronic inflammation. It is like a little lump of white blood cells that develops in response to the persistent chronic inflammation. Frequently occur in lungs, granulomas are non-cancerous growth of tissue and a result of an infection. It is a compact collection of macrophages, typically accompanied by helper T-cells. So, simply put granulomas are a kind of inflammation that your body uses to respond to an injurious or noxious stimulus. These are like little grape or bean shaped clusters that can form anywhere in the human body. Most granulomas fall into one of two categories: caseating and noncaseating. We take a detailed look at them and try to understand the differences between the two.

Caseating Granuloma

Tuberculosis is one of the perfect examples of a caseating granuloma. But what exactly are caseating granulomas? Most of the granulomas are caused by fungal infections and are characterized by the central areas of caseation necrosis, and are termed as caseating granulomas. It basically refers to necrosis that involves dead cells without nuclei and debris. Caseating means cheese like. So, caseating granulomas are so called because of their gross appearance of necrosis that is much like a cheese. While caseating granulomas are the classic findings in tuberculosis cases, they are not always present. Rarely, caseous necrosis is caused by fungi, syphilis, histoplasmosis, cryptococcosis, and other parasites. So, caseating granuloma looks like a nodule with lots of inflammatory cells around with the middle region being dead.

Noncaseating Granuloma

There are other granulomas that lack central caseation and are called noncaseating granulomas. They are also abnormal collection of chronic inflammatory cells which can form as nodules in multiple organs. Unlike caseating, noncaseating granulomas do not have a center that has undergone caseating necorsis, meaning it does not appear cheese like. One of the classic examples of noncaseating granulomas is sarcoidosis – a multi-organ, granulomatous condition characterized by T-cell dysfunction and B-cell hyperactivity with increased local immune activity and inflammation. This results in the formation of noncaseating granulomas. The most affected organs may be lungs and lymphatic system. Other common affected sites are heart, eye, central nervous system, skin, etc. 

Difference between Caseating and Noncaseating Granulomas

Nature

– Caseating granulomas are so called because of their gross appearance of necrosis that is much like a cheese. Granulomas characterized by the central areas of caseation necrosis are termed as caseating granulomas. They look like a nodule with lots of inflammatory cells around with the middle region being dead. Noncaseating granulomas, on the other hand, are granulomas that lack central caseation meaning they do not have a central region of necrosis.

Causes

– Caseating granulomas are non-cancerous growth of tissue that frequently occur as a result of an infection, such as tuberculosis and fungal infections. It’s like death of a cell that changes the appearance of the tissues to more like a cheese, hence the name caseating. The most common cause is tuberculosis where granulomas are formed in the lungs. Noncaseating granulomas, on the other hand, are formed when your body’s immune system is fighting off foreign objects but cannot completely eliminate them. They are commonly formed in response to an inflammatory condition, particularly sarcoidosis, or Crohn’s disease.

Caseating vs. Noncaseating Granulomas: Comparison Chart

Summary

In a nutshell, caseating granulomas are generally formed in response to some infections, particularly fungal infections or tuberculosis. Caseating granulomas are uniquely characterized by their cheese like appearance. They refer to necrosis that involves dead cells without nuclei and debris. Non-caseating granulomas, on the contrary, do not have a central caseation, which means the granulomas do not have a center that has undergone caseating necorsis like in caseating granulomas. Caseating granulomas are frequently caused by fungal infections in the lungs whereas non-caseating granulomas occur in response to exposure to some foreign object. Granulomas formation is characterized by some chronic condition.

What is a caseating granuloma?

Caseating granulomas are non-cancerous growth of tissue that frequently occur as a result of an infection, such as tuberculosis and fungal infections. They are characterized by the central areas of caseation necrosis, means it appears cheese like.

Is TB Caseating or Noncaseating?

Tuberculosis is generally caseating where granulomas are formed in the lungs. While caseating granulomas are the classic findings in tuberculosis cases, they are not always present there.

What are the two types of granuloma?

Granulomas typically can be categorized into two types: caseating granulomas and non-caseating granulomas.

What disease has Noncaseating granulomas?

Sarcoidosis is one of the classic examples of noncaseating granulomas. Other conditions are Crohn’s disease and necrotising sarcoid granuloma (NSG) which is very rare.

What is non-caseating mean?

Non-caseating means something that does not exhibit caseation. Unlike caseating, they do not have a central region of necrosis.

Is sarcoidosis a Caseating granuloma?

No. Sarcoidosis is a classic example of a non-caseating granuloma the etiology of which remains unknown. It is characterized by increased local immune activity and inflammation that may result in the formation of non-caseating granulomas.

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