Caseous necrosis of the lung
Caseous necrosis is a type of coagulation necrosis. The tissue affected by this type of necrosis is converted into a soft, white, proteinaceous cottage cheese-like (casein) mass. The causes of cheesy necrosis can be tuberculosis, syphilis and a special type of fungus.
Often, such a pathology is observed with deep, systemic mycosis, an infectious disease caused by yeast fungi, and with damage by dangerous dimorphic fungi. With caseous necrosis, the histological structure is completely destroyed, under the microscope you can see pink areas devoid of cells surrounded by a granulomatous inflammatory process.
Caseous necrosis of the lung is characterized by a yellowish-brown tint of the surface. In the case of severe destruction, cystic spaces appear. Curdled necrosis develops in the granuloma in the event of a change in the reactivity of the organism, as evidenced by fibrous transformations. In some cases, a strong increase in the tuberculous focus is possible, and subsequently its tendency to cheesy necrosis and destruction.
Cheese necrosis of the lung develops after caseous pneumonia. Approaching any surface and touching an organ or tissue, the focus is opened, allowing the curd mass to be emptied. In this case, cavities (extensive defects) are formed. The rapid liquefaction of the curdled masses contributes to the formation of a huge cavity. Clinical symptoms are expressed by impaired functions of the bronchopulmonary system, respiratory failure, serious changes in the functional systems of homeostasis.
The disease progresses very quickly, death is possible. The disease proceeds as manifestations of the intoxication syndrome, the body temperature rises and remains constantly up to 39-40 ° C. There is a lack of appetite, refusal to eat, a sharp and significant weight loss, diarrhea, weakness.
In patients, pain is localized in the chest area, shortness of breath appears, a wet cough with profuse sputum, often rusty in color. With extensive damage to the lung, necrosis is found in both the visceral and parietal pleura. If the disease is detected too early, there is every chance of a quick recovery. At a later date, an operation is scheduled.
Caseous lymph node necrosis
Lymph nodes belong to the defense organs in which lymphocytes are produced, which prevent harmful microbes from entering the body. In a healthy state, they are rounded, bean-shaped, less often spindle-shaped, slightly flattened. The length can be from a few millimeters to 2-3 cm. Near large blood vessels, lymph nodes form "clusters".
Any lymph node has adductor and discharge lymphatic vessels through which lymph flows. Foreign useful, including harmful substances, usually accumulate in the nodes. This is the filter of the organism. The lymphatic fluid passes through the lymph node, then enters the bloodstream, and from there to the liver and kidneys.
Swollen lymph nodes is an important symptom that indicates some pathological process in the body. When tuberculosis is affected, at the stage when it is replaced by tuberculous granuloma, the formation of caseous necrosis is a dangerous moment. In this case, the help of a surgeon is required, because the curd masses do not dissolve, but, on the contrary, become more and more dense, due to the deposition of calcium salts in them. Also, another unfavorable fact is not compaction, but purulent fusion of the caseous-transformed lymph node with pus.
If it breaks through, then a tuberculous fistula is formed, and a closed tuberculous process turns into an open one. If we consider caseous necrosis of the lymph node under a microscope, then in the cortical layer there is an accumulation of lymphocytes, tightly adjacent to each other. Their nuclei are dark blue, surrounded by rims of cytoplasm.
In some areas of the node, a pink mass is formed with a large number of blue lumps of various shapes and sizes. The lymph node usually increases in volume.
The boundaries between the cortical and medullary layers are erased, small foci appear, consisting of a dry crumbling mass of gray-white color, similar to dry cottage cheese, around which connective tissue is formed.
The changing structure of caseous necrosis of the lymph node leads to a chronic course. The disease becomes practically incurable with the help of drugs, because the blood vessels are stored only in the capsule of the node and therefore the penetration of fluid is excluded.
New diagnostic possibilities in the field of immunology and biochemistry make it possible to accurately determine the nature of pathological changes in the lymph node, which indicates the choice of treatment tactics.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
