Osteomyelitis

Osteomyelitis is an inflammation of bone marrow, the bones and the periosteum often. It can occur as a result of hematogenous infection of bone or as a complication of trauma with injury bones. Osteomyelitis pathogens are microorganisms from the group of staphylococci or streptococci. Perhaps the development of osteomyelitis tuberculous etiology. Currently experimentally confirmed, which osteomyelitis occurs sensitized body.

Hematogenous osteomyelitis It develops mainly in children and young adults. The disease acute, as in infectious or septic process. In the beginning there is a serous inflammation edema, and later there is necrosis of the bone marrow with a pronounced leukocyte reaction. Along the vascular system and nutrient channels of the inflammatory process extends to the periosteum, which may arise periosteal abscess. As a result, the power of the periosteum detachment broken bones - there are bony sequesters, which can cause the formation of fistulas, and the transition process of acute to chronic.

At chronic osteomyelitis It is going delimitation ulcers, containing sequesters, granulation, fibrous or bone tissue in the form of capsules.

If it is impossible to recognize the disease clinically and radiologically resorted to puncture. The punctate on a background of purulent detritus found preserved and dilapidated neutrophilic granulocytes, macrophages, gistiocitы, plasma cells, fibroblasts and giant multinucleated cells of foreign bodies, less eosinophilic granulocytes and lymphocytes.

The quantitative ratio of cells in a punctate different and depend on the stage of development of pathological process, and the reactivity of the organism. Tubercular process in the bones confirmed the discovery of giant multinucleate cells Pirogov-Langhans, epithelioid cells and Mycobacterium tuberculosis.

Eosinophilic granuloma – disease Taratynova

Currently, eosinophilic granuloma combined with disease and Letterer-Zive Henda- Christian-Shyullera under the title gistiocitozы, because the morphological substrate in this disease is the proliferation of reticular cells. These growths, some authors believe tumors, others - border (between the tumor and hyperplasia) Diseases.

Along with the reticular cells in eosinophilic granuloma found a large number of eosinophilic granulocytes. Disease develops in childhood and adolescence (Sometimes adults), It occurs mostly benign. Localized eosinophilic granuloma may at any bones, in the skin and some internal organs (light, lymph nodes, spleen).

Punctate eosinophilic granuloma It has the characteristic macroscopic appearance. Usually this bloody clot with grayish-whitish streaks kroshkovidnymi, used to prepare drugs for microscopic examination. The characteristic morphological elements are punctate reticular cells and eosinophilic granulocytes.

These cells may be found in various combinations: in some cases dominate eosinophilic granulocytes, in others - reticular cells, among which, as it were sprinkled with eosinophilic granulocytes. Eosinophilic granulocytes predominantly mature, have a round nucleus. Reticular cells are typically medium and large sizes, oval or circular large nucleus. There may be two- and triple-cells. Cytoplasmic reticular cells colored in light blue tones. The punctate also found macrophages, plasma cells, polynuclear giant cells of osteoclast type, a small amount of lymphocytes and neutrophils. Sometimes revealed Charcot-Leyden crystals.

Eosinophilic granuloma should be differentiated from Hodgkin's disease where, when not detected punctate Berezovsky-Sternberg cells. It should also be borne in mind, that radiotherapy to bone lesion puncture can cause eosinophilic granulocytes. To avoid errors in the interpretation of cytologic preparations should include the clinical data.