Path/Histo help

[Murphy Brown]

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I just can't see the difference between a caseating vs. a non-caseating granuloma. I understand the definition of each, but when looking at photos, I can't tell the difference most of the time. Sometimes it's obvious but other times, I don't get it. Can someone help?

 

[RySerr21]

I just can't see the difference between a caseating vs. a non-caseating granuloma. I understand the definition of each, but when looking at photos, I can't tell the difference most of the time. Sometimes it's obvious but other times, I don't get it. Can someone help?

the good news I dont think you really to. You're never gonna just get a picture and have them ask you what it is. Its gonna be in the context of something, some clinical presentation. If you just know which diseases have caseous and non caseous granulomas (there arent very many) you are fine. If they are describing someone with TB and they show yuo a picture of a granuloma, its gotta be caseous. If tehy are describing someone with sarcoidosis, its gotta be non-caseous.

 

[MedStudentWanna]

the good news I dont think you really to. You're never gonna just get a picture and have them ask you what it is. Its gonna be in the context of something, some clinical presentation. If you just know which diseases have caseous and non caseous granulomas (there arent very many) you are fine. If they are describing someone with TB and they show yuo a picture of a granuloma, its gotta be caseous. If tehy are describing someone with sarcoidosis, its gotta be non-caseous.

I don't know that that's true. In my path class, we were given photos and had to make a diagnosis based on the photo. If it was a granuloma, you narrowed down your answers. But almost always, there was a non-caseating granuloma disease (sarcoid) and a caseating granuloma disease (TB) among the answer choices so you had to be able to differentiate between them to get the right answer.

This always messed me up too.

 

[RySerr21]

I don't know that that's true. In my path class, we were given photos and had to make a diagnosis based on the photo. If it was a granuloma, you narrowed down your answers. But almost always, there was a non-caseating granuloma disease (sarcoid) and a caseating granuloma disease (TB) among the answer choices so you had to be able to differentiate between them to get the right answer.

This always messed me up too.

Let me clarify - if you are taking a pathology class which asks you useless questions that give you no backgound or history and require you to make a diagnosis based on a picture....then yea that sucks. But in reality, for the boards and for life, that will never happen. 99% of us are not training to be pathologists, i dont know why this seems to be a common way for schools to ask medical students questions on exams. I'm sure even pathologists get a background/history. You don't just throw a slide at a pathologist and ask him/her what it is.

 

[twentyone]

You don't just throw a slide at a pathologist and ask him/her what it is.

Only on the path boards


OP: For pathology course purposes, caseating granulomas will have "junk" in the middle- pink stuff and debris with no cellular detail. In a non-caseating granuloma you will be able to make out cellular detail of the histiocytes in the center.

 

[OveractiveBrain]

Only on the path boards


OP: For pathology course purposes, caseating granulomas will have "junk" in the middle- pink stuff and debris with no cellular detail. In a non-caseating granuloma you will be able to make out cellular detail of the histiocytes in the center.

Caseating = necrotic = dead cells = just pink, no purple

Non-caseating = non necrotic = live cells = purple amongst the pink.

Look at RR Goljan

 

[OveractiveBrain]

Only on the path boards


OP: For pathology course purposes, caseating granulomas will have "junk" in the middle- pink stuff and debris with no cellular detail. In a non-caseating granuloma you will be able to make out cellular detail of the histiocytes in the center.

Caseating = necrotic = dead cells = just pink, no purple

Non-caseating = non necrotic = live cells = purple amongst the pink.

Look at RR Goljan or....

Caseating... look at the pink surrounded by purple

Noncaseating.... purple inside the pink, distributed throguhout. The purple are cells. The pink is granuloma