Types of granuloma Pathology

Pathology Outlines - Granulomatous lesion

  1. An inflammatory condition with formation of a granuloma(s) in the prostate < 1% of prostate specimens (J Urol 1987;138:320) Nonspecific granulomatous prostatitis is the most common type, comprising > 50% of cases (Hum Pathol 1984;15:818, Yang: Atlas of Practical Genitourinary Pathology, First Edition, 2014) Includes nonspecific, postprocedural, infectious, systemic and secondary granulomatous.
  2. The pathology of the mature granuloma is caused by several factors: 1) It is a space-occupying lesion that physically impinges on the neighboring tissue. 2) Leakage from activated macrophages of cytokines (TNFα), oxygen (H2O2, O2­, OH•, O2•) and nitrogen (NO) derivatives and proteolytic enzymes that damage the neighboring tissue
  3. Granulomas with distinctive finely vacuolated cells (Virchow cells) in leprosy Rarely, foreign body granulomas can occur Mycobacteria: clusters of histiocytes with needle-like inclusions resembling Gaucher cells ( J Clin Pathol 2005;58:1113 ); rarely hemophagocytosis in dialysis patients with T

1. Int J Dermatol. 1984 Oct;23(8):531-8. Pathology of granulomatous diseases. Foreign body granulomas. Hirsh BC, Johnson WC. PMID: 6209232 [PubMed - indexed for MEDLINE Granulomas are sub-classified into about four types. They can be tuberculoid, sarcoidal, pallisading or infectious (Suppurative). Various diseases present as different types of granulomas. Foreign body material can cause any type of granuloma but usually it is sarcoidal

Granulomatous Diseases - Infectious Disease and

  1. Tuberculosis is the prototype of granulomatous disease caused by infection. The activated macrophages in these granulomas are large, polygonal and have an oval/ elongated pale staining nuclei and they look like epithelial cells. Hence these cells are called as Epithelioid cells
  2. The granulomatous inflammatory response is a special type of chronic inflammation characterised by often focal collections of macrophages, epithelioid cells and multinucleated giant cells. In this review the characteristics of these cells of the mononuclear phagocyte series are considered, with part
  3. There are five main types of granuloma annulare. It is possible to develop more than one type of granuloma annulare at the same time. Localized granuloma annulare: The most common form of the condition, localized granuloma annulare causes a circular rash on the skin that may begin as small circles that later merge together
  4. Localized granuloma annulare: This is the most common form. Localized granuloma annulare is characterized by skin-colored to violaceous lesions up to 5 cm in diameter. Usually, the epidermis has..
  5. TYPES OF GRANULOMAS 25. FOREIGN BODY Talc, Suture material NECROTISING GRANULOMAS Mycobacterium Tuberculosis, Histoplasma Capsulatum, Granuloma Annulare NON NECROTISING GRANULOMAS M.Leprae, Sarcoidosis, SLE, SUPPURATIVE GRANULOMAS Actinomyces, Chlamydia Trachomatis HISTIOCYTIC RESPONSE, NO GRANULOMAS Listeria Monocytogenes,Mycosis Fungoides 26
  6. Examples of this use of the term granuloma are the lesions known as vocal cord granuloma (known as contact granuloma), pyogenic granuloma, and intubation granuloma, all of which are examples of granulation tissue, not granulomas

Pathology Outlines - Granulomatous inflammatio

Granulomas in ITB cases were denser than those in CD cases (mean 5.29 ± 4.30 vs. 2.46 ± 3.50 granulomas per 10 low power fields; each low power field = 3.80 mm; P = 0.005). Granulomas in ITB cases were larger (mean widest diameter, 508 ± 314 μm; range, 100-1100 μm) than those in CD cases (mean widest diameter, 253 ± 197 μm; range, 50-800. Three cases are reported, and the literature is reviewed to illustrate the varying features of tissue reaction to silicone in its different forms. The first case is an example of silicone lymphadenopathy in an inguinal lymph node. This case demonstrates exuberant foreign body granuloma formation in response to particles of silicone elastomer

Pathology Granuloma annulare microscopically consists of dermal epithelioid histiocytes around a central zone of mucin—a so-called palisaded granuloma Granuloma. A granuloma is a foreign-body reaction whereby a tissue recruits many immune cells from the blood to surround and wall off foreign bodies with inflammatory cells and fibroblasts. From: Haschek and Rousseaux's Handbook of Toxicologic Pathology (Third Edition), 2013. Download as PDF. About this page Pyogenic granuloma (PG) is a polypoid form of lobular capillary hemangioma that usually occurs in the skin and some mucosal surfaces. However, it is extremely rare in the intestinal tract and its preoperative diagnosis is difficult. We report on a case of PG of the sigmoid colon in a 62-year-old woman with a 6-month history of rectal bleeding

Granuloma annulare (GA) is a skin disorder of uncertain etiology. Patch (type) GA is an uncommon variant of GA with a paucity of data characterizing it. We describe the features of 23 cases of patch GA Giant cells are big cells with multiple nuclei. They come in different flavours, which are suggestive of causality. This article deals with the classic types of giant cells. A more general differential diagnosis of giant cells is in giant cell lesions JOSÉ ANTONIO PLAZA, VICTOR G. PRIETO, in Modern Surgical Pathology (Second Edition), 2009. Granuloma Annulare. Granuloma annulare is a common benign dermatosis characterized clinically by dermal papules and annular plaques. Localized granuloma annulare is the most common variant and is characterized by multiple red annular lesions usually located in acral sites The formation of granulomas of this type is associated with a poor prognosis. By contrast, patients with partial IFN- the role of angiostasis and CXCR3-targeted chemokines for granuloma necrosis, Journal of Pathology, vol. 212, no. 3, pp. 295-305, 2007 Granulomatous diseases are the heterogeneous group of the conditions of different etiologies with a variety of clinic syndromes and morphological features and nonuniform sensitivity to therapy, and the existence of granulomas as general dominate histological expression. Granuloma is indicative of chronic inflammation involving cells of the macrophage system and other inflammatory cells

Pathology of granulomatous diseases

  1. Several types of granuloma can affect the skin. The most common is granuloma annulare, a harmless skin condition that causes raised pink or flesh-coloured bumps under the skin. The bumps are usually found over bony areas, like the elbow, and may have a distinctive ring shape. They often affect hands and arms, but can also affect legs, feet.
  2. Pathology Granulomas are classified into caseating and non-caseating granulomas. Caseation is a macroscopic description of a form of necrosis that resembles cheese. It is highly suggestive of tuberculosis but can also occur in other granulomatous diseases like histoplasmosis (a form of fungal infection)
  3. A granuloma is a type of chronic inflammation that forms in an attempt to contain and remove a harmful agent from the body. Granulomas are made up of specialized immune cells including lymphocytes, histiocytes, and multi-nucleated giant cells. Pathologists use the word granulomatous to describe the microscopic look of granulomas inside tissue

Differential Diagnosis in Dermatopathology: Granuloma

Granuloma - Focal collection of inflammatory cells at sites of tissue infection and includes activated macrophages (epithelioid cells), Langhans' giant cells, and lymphocytes. Caseation necrosis - Regions in granulomas with eosinophilic, granular, and friable (cheeselike) cellular debris with necrosis Granulomatous inflammation - A distincti.. COMMENT: The granuloma (Part D) is histologically favoured to be nonspecific (as most prostate granulomas are); however, this finding should be interpreted within the clinical context. Periprostatic foreign body-type D. PROSTATE, RIGHT MEDIAL MIDZONE, BIOPSY: - BENIGN PROSTATE TISSUE; - FOREIGN BODY-TYPE GRANULOMA, NON-NECROTIZING, SEE COMMENT Granuloma annulare and interstitial granulomatous dermatitis may appear similar clinically and histologically. Granuloma annulare also presents with papules and plaques, but these are typically on the back of the hands or feet, whereas the trunk is a more common site for interstitial granulomatous dermatitis Lung Granuloma: Symptoms, Causes, and Treatments. Granulomas are small lumps of immune cells that form in your body in areas where there is infection or inflammation. They're most commonly found. The natural history of foreign body granuloma varies depending on the cause. Foreign body granulomas and abscesses due to bovine collagen injections often regress spontaneously within 1-2 years [2-4]. Other types of foreign body granuloma may persist for decades

This article will help you read and understand your pathology report for pyogenic granuloma. by Jason Wasserman MD PhD FRCPC, reviewed by our Patient Partners on November 13, 2020. Quick facts: Pyogenic granuloma is a common non-cancerous type of tumour made up of blood vessels and inflammatory cells As infectious necrotizing granulomas may exhibit coagulative type necrosis, The surgical pathology of pulmonary infarcts: diagnostic confusion with granulomatous disease, vasculitis, and. In immune system disorder: Tuberculin-type hypersensitivity this sort is termed a granuloma. Immunity to a number of other diseases (for example, leprosy, leishmaniasis, coccidiosis, and brucellosis) also can be gauged by the presence or absence of a delayed reaction to a test injection of the appropriate antigen BRUCE M. WENIG, MARY RICHARDSON, in Modern Surgical Pathology (Second Edition), 2009 Giant Cell (Reparative) Granuloma. Giant cell granuloma is a benign reactive osseous proliferation that shares many features with aneurysmal bone cyst; in many regards, these lesions are indistinguishable. 124 In the head and neck area, the most common sites of occurrence are the maxilla and mandible Giant cell tumour of the tendon sheath. Undifferentiated pleomorphic sarcoma with giant cells. Osteosarcoma with giant cells. Giant cell reparative granuloma ( AKA solid aneurysmal bone cyst ). Brown tumour. Sarcoidosis. Other granulomatous disease. Foreign body giant cells. Choriocarcinoma

Understanding Your Pathology Report: Colon Polyps (Sessile or Traditional Serrated Adenomas) When your colon was biopsied, the samples taken were studied under the microscope by a specialized doctor with many years of training called a pathologist.The pathologist sends your doctor a report that gives a diagnosis for each sample taken Granuloma annulare (GA) is a skin disorder of uncertain etiology. Patch (type) GA is an uncommon variant of GA with a paucity of data characterizing it. We describe the features of 23 cases of patch GA. Methods. The archives of dermatopathology were searched for cases of patch GA. The clinical history and morphology for each patient were reviewed A lung granuloma is a localized collection of inflammatory cells. The commonality among granulomas is that they occur as a normal bodily process in which the body attempts to contain something foreign in the lungs. In other words, a granuloma is essentially an area of microscopic quarantine in the lungs Granuloma annulare may be a delayed hypersensitivity reaction to a component of the dermis or a reaction pattern to numerous triggers. Reported triggering events have included many skin infections and infestations, and types of skin trauma. Inflammation is mediated by tumour necrosis factor alpha ( TNF α). The reason this occurs is unknown Dermatopathology is a subspecialty of pathology. Pathology is the study of diseases. It includes the study of the causes, course and progression and the complications that arise from the disease. Anatomic pathology, or histopathology, refers to the study of the structural and compositional changes that occur in organs and tissues as a result of.


Granuloma annulare (gran-u-LOW-muh an-u-LAR-e) is a skin condition that causes raised reddish or skin-colored bumps (lesions) in a ring pattern. The bumps are usually on the hands and feet. Minor skin injuries and some drugs might trigger the condition. Different types affect adults and children Erosion of non-necrotic muscle fibers around & along their edges by Histiocytic granuloma cells. Congo red stain. Replacement of Muscle fibers by Histiocytic granuloma cells. Acid phosphatase stain. MHC expression by muscle fibers & granuloma cells. Control muscle: MHC expression only in vessels. Other immune features Granuloma annulare can be subclassified into subcutaneous and interstitial. Histomorphologically similar to Rheumatoid nodule. Neutrophils may be seen. Necrobiosis lipoidica - little mucin, no normal dermis between foci, plasma cells - common, may involve the fat - tend to be deeper

Pathology. Granuloma annulare microscopically consists of dermal epithelioid histiocytes around a central zone of mucin—a so-called palisaded granuloma. [citation needed] Diagnosis Types. Granuloma annulare may be divided into the following types:: 703-5. Localized granuloma annulare; Generalized granuloma annular A short tutorial giving an overview of what granulomas are, what causes them and how to recognise them. The video is illustrated with several examples of con.. Periapical pathology. 1. PRESENTED BY Dr EKTA GARG MDS 1st YEAR DEPARTMENT OF CONSERVATIVE DENTISTRY & ENDODONTICS. 2. Consists of cementum, pdl and alveolar process. CEMENTUM Mineralized, avascular connective tissue covering the roots of the teeth. Consists of 3 different types- • Acellular afibrillar cementum • Acellular extrinsic fiber. Early in the formation of a granuloma there may be no surrounding lymphocytes. This is called a naked granuloma. Several types of cytoplasmic inclusion bodies can accompany granulomatous inflammation including: laminated calcific Schaumann bodies, stellate asteroid bodies, and small oval brown Hamasaki-Weseberg bodies. These inclusion bodies are common in sarcoidosis but are nonspecific The granuloma is maintained by a delayed-type hypersensitivity (DTH) response to the persistent presence of antigens and immunostimulatory lipids, as Mtb can survive within macrophages and extracellularly within the granuloma. 138 The caseum is predominantly composed of host-derived lipids, and a recent analysis of gene regulation in the.

Sarcoidosis - Honeycombing | Prominent honeycombing is

General Information. This is a benign proliferation of Langerhans cells usually accompanied with eosinophils, lymphocytes, neutrophils and scattered plasma cells. There may be solitary or multiple lesions confined to bone. 70% of cases consist of a solitary lesion. Seldom leads to disseminated systemic disease The peripheral giant cell granuloma is a hyperplastic reaction of the gingival connective tissue in which the histiocytic and endothelial cellular components predominate. These two cell types are intermingled and arranged in a lobular pattern separated by a fibrous connective tissue containing large sinusoidal blood vessels 1. Urology. 1976 Jul;8(1):89-91. Plasma cell granuloma of kidney. Fisch AE, Brodey PA. A case report of a plasma cell granuloma presenting as a solitary avascular intrarenal mass lesion is presented with angiographic and ultrasonic findings PYOGENIC GRANULOMA Dr Amitha. 2. Common Inflammatory hyperplasia. Non-neoplastic, painless. The name is a misnomer since: no pus , not granuloma. Tumor like. Nodular growth in the oral cavity. INTRODUCTION. 3. Surface: Usually ulcerated Color: Red-to-purple. Smooth or lobulated Pedunculated or sessile Granuloma annulare (GA) is skin disorder that most often causes a rash with red bumps (erythematous papules) arranged in a circle or ring pattern (annular). GA is not contagious and is not cancerous. The rash may be localized or generalized. Localized GA is the most common form of GA (75% of the cases) and usually affects the forearms, hands, or feet

Granulomatous inflammation--a revie

  1. antly in tropical areas and characterized by deep purulent ulcers on or near the genital organs. Encapsulated bacilli called Donovan bodies (Calymmatobacterium granulomatis) occur in smears from the lesions or in biops
  2. e and compare the clinical features, etiological factors, diameter of vascular elements and immunohistochemical features of LCH and non-LCH histological types of PG to deter
  3. Impact of interleukin-13 responsiveness on the synthetic and proliferative properties of Th1- and Th2-type pulmonary granuloma fibroblasts. Jakubzick C(1), Choi ES, Kunkel SL, Joshi BH, Puri RK, Hogaboam CM. Author information: (1)Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA
  4. Granulomas are organised conglomerates of histiocytes, a specialised white blood cell 1.They form by the process of granulomatous inflammation, which is a specific type of chronic inflammation that occurs following cellular injury as a response to the mediators that are released.A broad range of insults, including infections, autoimmune, foreign bodies, allergens and neoplastic disease, may.
  5. A complete organized library of all my videos, digital slides, pics, & sample pathology reports is available here: https://kikoxp.com/posts/5084 (dermpath) &..
  6. Cutaneous granulomas in the setting of a systemic lymphoma are of two types. The first type is characterized by granulomatous infiltrates admixed with neoplastic cells within specific skin lesions of malignant lymphomas. The second type consists of granulomatous skin processes that are non-specific manifestations of the underlying lymphoma
  7. ation underpolar-ised light

Granuloma Annulare: Types, Causes & Treatment

Periapical granuloma, also sometimes referred to as a radicular granuloma or apical granuloma, is an inflammation at the tip of a dead (nonvital) tooth. It is a lesion or mass that typically starts out as an epithelial lined cyst, and undergoes an inward curvature that results in inflammation of granulation tissue at the root tips of a dead tooth. This is usually due to dental caries or a. GA usually causes no other symptoms, but the rash may be slightly itchy. People usually notice a ring of small, firm bumps (papules) over the backs of the forearms, hands, or feet. Occasionally, they may find a number of rings. In rare cases, GA appears as a firm nodule under the skin of the arms or legs. In some cases, the rash spreads all.

Pyogenic granuloma or lobular capillary hemangioma is a vascular tumor that occurs on both mucosa and skin, and appears as an overgrowth of tissue due to irritation, physical trauma, or hormonal factors. It is often found to involve the gums, the skin and nasal septum, and has also been found far from the head such as in the thigh.. Pyogenic granulomas may be seen at any age, and are more. Introduction. Feline eosinophilic granuloma complex includes three types of lesions: Eosinophilic or rodent ulcers which present as a well circumscribed, erythematous ulcer on the lip or oral mucosa of middle-aged cats; Eosinophilic plaques which present as raised erythematous lesions on the skin of the medial thighs and abdomen; Eosinophilic or linear granuloma which present on the posterior.

What are the types of granuloma annulare

Eosinophilic Granulomas are self-limiting benign histiocytic lesions that can occur in isolation or as a part of 2 systemic syndromes: Hand-Schuller-Christian (HSC) disease and Letterer-Siwe disease (LSD). Isolated lesions typically present with pain in the thoracic spine or long bones in patients < 20 years of age Granulomas are organized conglomerates of histiocytes, a specialized white blood cell 1.They form by the process of granulomatous inflammation, which is a specific type of chronic inflammation that occurs following cellular injury as a response to the mediators that are released. A broad range of insults, including infections, autoimmune, foreign bodies, allergens and neoplastic disease, may. of granulomas is also vital in order to limit the egg-antigen induced inflammation that would otherwise lead to permanent inflammatory tissue damage and extensive necrosis, as seen in the increased mor-tality in mansoniS-infected T cell-depleted mice.31 Thus, although the formation of the schistosome granuloma is the key pathology i Pathology of granulomatous diseases: foreign body granulomas. Int J Dermatol. vol. 23. 1984. pp. 531-8. (In this review, the authors discuss the distinguishing clinical and histopathologic findings in various foreign body granulomas.) Hirsch, BC, Johnson, WC. Pathology of granulomatous diseases: epithelioid granulomas, part II phocyte infiltration among granuloma cells.In addition, the border of granulomas is often obscure (Fig.2a, 2b). T lym-phocytes, dendritic cells and macrophages are important com-ponents for granuloma formation.A CD4/CD8 ratio of 0.8 to 2.25 is observed in confluent-type rather than solitary-type granuloma.23 The clinical course and laboratory.

Granulomatous inflammation - SlideShar

Pathology of Tuberculosis. Return to the tutorial menu. tuberculosis: seen as an initial infection, usually in children. The initial focus of infection is a small subpleural granuloma accompanied by granulomatous hilar lymph node infection. Together, these make up the Ghon complex. The TB skin test is based upon the type 4. Suppurative lesions without prominent epithelioid cell response in abscess-forming granulomatous lymphadenitis. Kojima M, Nakamura S, Kurabayashi Y, Itoh H, Yoshida K, Asano S, Suchi T, Joshita T. Pathol Res Pract. 1995 Nov;191 (11):1072-77 Majocchi granuloma can be defined as a deep folliculitis due to a cutaneous dermatophyte infection. [] Majocchi granuloma is most commonly due to Trichophyton rubrum infection. Majocchi granuloma tends to occur in young women who frequently shave their legs, although Majocchi granuloma also is seen in men. [] Majocchi granuloma also commonly occurs as a result of the use of potent topical. Types of Ovarian Cancer. There are three main types of ovarian tumors: Epithelial tumors - derived from the cells on the surface of the ovary. This is the most common form of ovarian cancer and occurs primarily in adults. Germ cell tumors - derived from the egg producing cells within the body of the ovary. This occurs primarily in children and. Similar appearances in oral pathology: Is it a peripheral ossifying fibroma or a pyogenic granuloma? Nancy Burkhart, RDH, reviews a case where the diagnosis in oral pathology could be either a peripheral ossifying fibroma or a pyogenic granuloma

cutaneous granuloma - Humpath

Granuloma - Wikipedi

Understanding Your Pathology Report: Barrett's Esophagus (With or Without Dysplasia) When your esophagus was biopsied with an endoscope, the samples taken were studied under the microscope by a specialized doctor with many years of training called a pathologist.The pathologist sends your doctor a report that gives a diagnosis for each sample taken Granulomas are structures seen under the microscope that are often, although not always, caused by certain types of infections. Sometimes, the germs causing the infection can only be seen with special stains (such as GMS, stains for AFB, and PAS) that the pathologist applies to the microscopic slides

Granuloma - StatPearls - NCBI Bookshel

This type of epulis is neither pyogenic (pus producing) nor a true granuloma, but it is a vascular lesion.About 75% of all pyogenic granulomas occur on the gingiva, growing beneath the gingival margin, although they may also occur elsewhere in the mouth or other parts of the body (where the term epulis is inappropriate). This common oral lesion is thought to be a reaction to recurrent trauma. Goto, K, Ogawa, K. Lanthanum deposition is frequently observed in the gastric mucosa of dialysis patients with lanthanum carbonate therapy: a clinicopathologic study of 13 cases, including 1 case of lanthanum granuloma in the colon and 2 nongranulomatous gastric cases. Int J Surg Pathol. 2016; 24: 89 - 92 Pathology of Conjunctiva Tatyana Milman The conjunctiva is a mucous membrane that plays a critical role in maintaining ocular health by forming a smooth, flexible, and protective sac covering the pericorneal surface of the eye.1 An intact conjunctiva forms a barrier to entrance of infectious organisms and provides immune surveillance and immunoreactivity for antigenic stimuli First described in 1895 [ 1 ], granuloma annulare (GA) is a relatively common, often self-limited disorder that can affect both children and adults. Localized GA, which classically presents as a nonscaly, erythematous, annular plaque on the distal extremity is the most common form of GA. The generalized form of GA, which accounts for.

The Histopathological Spectrum of Pyogenic Granuloma: A

Another type of light therapy, laser treatments, can also be helpful. Some cases of granuloma annulare can be stubborn. The first treatment you try may not work. For this reason, dermatologists use different treatments that can help clear the skin. While granuloma annulare is not an infection, an antibiotic may help be helpful for some people Oral Pathology Clinical Review 7 1. Fibroma 7 2. Pyogenic Granuloma 8 3. Peripheral Ossifying Fibroma 10 4. Peripheral Giant Cell Granuloma 11 5. Gingival Overgrowth 12 6. Gingival Cyst 13 7. Benign Migratory Glossitis 14 8. (Pseudomembranous) Candidiasis 15 9. Apthous Ulcer 16 10. Herpetic Stomatis 18 11. Herpes Zoster (Shingles) 19 12 A granuloma is a benign growth resulting from irritation or trauma. It is usually found at the back of the vocal fold, over a part of cartilage called the vocal process, which lies just underneath the membrane covering the larynx. Because there is little overlying soft tissue for cushioning, it is prone to trauma from impact with the vocal. Oral Pathology of Traumatic Ulcerative Granuloma and TUGSE May 9, 2019 Oral Pathology and Radiology Vesicular Ulcerative Conditions Audrey L. Boros MSc., DDS In this article we'll review pictures from a patient that had a dental procedure and then a few days later noticed concerning ulcerations on their lip resulting from post-operative trauma

Langhans cells - HumpathEpulis: Clinical features, Incidence, Etiology, DiagnosisFlashcards - Oral Pathology Chcapillary hemangioma - Humpath

Diagnostic Criteria. The diagnosis of Crohn disease requires clinicopathologic correlation. Inflammation is transmural, from mucosa to serosa. Lymphoid aggregates present at all levels. Infiltrate in some cases is more prominent in submucosa and serosa, with relative sparing of muscularis propria. Especially in early cases Incidental chronic colitis as defined here may be histologically indistinguishable from focal colitis associated with diverticular disease; Incidental colitis is virtually restricted to the cecum/right colon while diverticular disease is usually left side Kempson RL, Fletcher CDM, Evans HL, Henrickson MR, Sibley RS. Tumors of the Soft Tissues, Atlas of Tumor Pathology, AFIP Third Series, Fascicle 30, 2001; Fletcher CDM, Unni KK, Mertens F. Pathology and Genetics of Tumours of Soft Tissue and Bone, World Health Organization Classification of Tumours 2002; Weiss SW, Goldblum JR Granuloma Annulare Pathology. Granuloma annulare is a skin condition that is quite common, which most often affects children and young adults, but can occur at any age. In most cases, a ring-shaped annular patches occur in just one or two sites of the body, often on bone area like the back of the hand, elbow or ankle The significance and natural history of unexplained pulmonary necrotizing granulomas are unknown. We reviewed patients in whom resected pulmonary necrotizing granulomas were unexplained at the time of histologic diagnosis to (1) learn whether a cause could be determined by reexamining histologic findings, incorporating microbiologic and laboratory data, and obtaining clinical follow-up; (2.