The chief difference in the granulomas of tuberculosis and other granulomatous conditions like brucellosis, mycosis and sarcoidosis is (pathologically)
|A||Presence of giant cells|
|B||Presence of caseation necrosis|
|C||Presence of epithloid cells|
|D||Presence of lymphocytes around the periphery of the lesion|
Presence of caseation necrosis
a. In granulomas because of tuberculosis the tubercle undergo caseation in the centre after about two weeks. This is caused by the protein fraction of tubercle bacilli.
b. The caseous material may soften and liquefy, presence of caseation necrosis is almost diagnostic of tuberculous pathology. A tubercle may not show caseation under the influence of antituneruclar drugs.