Caseous Necrosis

Caseous Necrosis

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Answer:

When the necrosed tissue is converted into a soft cheese-like mass, it is called caseous necrosis.

• Such necrosis occurs in cases of granuloma production by tuberculosis and fungal infections.
• It combines features of both coagulative and liquefactive necrosis.

Caseous necrosis

Caseous Necrosis Pathogenesis

It is due to a delayed hypersensitivity reaction to mycobacterial capsular antigens.

Caseous Necrosis Gross Appearance

Caseous necrosed tissue looks soft, granular, and yellowish and resembles dry cheese. Its appearance is due to the cytotoxic effects of lipopolysaccharides present in the capsule of M. tuberculum.

Caseous necrosis histology

Caseous Necrosis Microscopic Appearance

• Microscopically, the central part of the granuloma shows a finely granular structure with less material that contains fragments of cells and nucleic acids.
• Surrounding tissue shows characteristic granulomatous inflammatory reactions consisting of epithelioid cells, Langhans and foreign body giant cells, and a peripheral mantle of lymphocytes.
• Sometimes, dystrophic calcification can be seen.