[Histomorphology and immunopathology of granulomatous inflammation]

Every inflammation has its morphological substrate, however, not every morphological substrate is specific for a particular disease. On one side, this is due to the limited reaction spectrum of the organism, on the other side, to the fact that completely different etiological agents are able to activate the same pathomechanism. Since this holds true for granuloma formation also, the term "specific inflammation" has to be restricted considerably today. On the other hand, recent progress in the field of mediators of inflammation frequently permits a pathogenetic classification of granulomatous inflammatory processes - even before the etiology has been clarified (e.g. Morbus Boeck). In addition, the possibility to identify "granuloma cells", in particular macrophage- and lymphocyte-subpopulations, in situ by immunohistological means (by monoclonal antibodies to surface markers) expands the scope of conventional histomorphological techniques significantly.