The document discusses chronic inflammation, its causes, effects, and the role of giant cells, particularly in the context of tuberculosis. Chronic inflammation is defined as a prolonged response, often resulting from persistent infection, exposure to toxic agents, or autoimmunity, and is characterized by histological features such as mononuclear infiltration and tissue destruction. Granulomas, a type of chronic inflammation response, consist of epithelioid cells and multinucleate giant cells and are formed due to type IV hypersensitivity reactions.

1. Topic :-
1)Chronic inflammation
2)Giant cells
3)Tuberculosis
Presented by: Murtem Tania(RollNo:24)

2. INFLAMMATION
Definition:” Local response of living mammalian
tissues to injury from any agent. It’s a body
defense reaction in order to eliminate or limit the
spread of injurious agents,followed by removal
of the necroses cells and tissues”
It is characterised by:
}Redness
}Swelling
}Heat
}Pain
Inflammation of 2types
1)Acute inflammation
2)Chronic inflammation

3. *(CHRONIC INFLAMMATION)
Defined as “long lasting
prolonged inflammatory
response”
Destruction and inflammation
occur at the same time.

4. Causes of Chronic inflammation
1)Persistent infection
>Organism of low toxicity that invoke delayed hypersensitivity reaction.
eg: M.tuberculosis & T.pallidum.
2)Prolonged exposure to potentially toxic agent
>Exogenous agents like Silica—->Silicosis
>Endogenous cause atherosclerosis—->Toxic plasma lipid components.
3)Autoimmunity
>Auto-antigens provoke self-perpetuating immune response
Eg- Rheumatoid arthritis,Multiple sclerosis
>Response against common environmental substances
Eg-Bronchial asthma

5. General features
Histological features
Mononuclear infiltration (Macrophages,lymphocytes and plasma cells) due
to persistent reaction to injury .
Tissue destruction induced by persistent agent or inflammatory cells.
Proliferative changes Attempts at healing by connective tissues,
replacement of damaged tissue with angiogenesis and fibrosis.

7. Image showing chronic inflammation

8. Cellular players
a)Macrophages
b)Lymphocytes
c)Plasma cells
d)Eosinophils
e)Mast cells

9. Systemic effects of chronic inflammation
1)Fever
2)Anaemia
3)Leucocytosis(predominantly lymphocytes)
4)ESR(elevated in chronic inflammation)
5)Amyloidosis

10. Types of chronic inflammation
Chronic non-specific inflammation:
Irritant——->non-specific chronic inflammatory
reactions——>Granulation tissue and tissue
repair by fibrosis.
Eg Chronic osteomyelitis,Chronic ulcer,Lungs
abscess.
Chronic granulomatous inflammation :
Etiological agent causes a characteristic
morphological tissue response by formation of
granuloma.
Eg tuberculosis,Syphilis etc Thank you

11. What is granuloma??
Its a circumscribed collection of epithelioids cells surrounded at the periphery by
lymphocytes and may contain a few multinucleate giant cells.
Its formation is type IV Hypersensitivity reaction .

12. EVOLUTION OF GRANULOMA
1) Engulfment by Macrophages
2) CD4+ Tcells
3) Cytokines
4) Growth factor
Morphology of Granuloma
1) Epithelioid cells
2) Multinucletae giant cells(eg: Langhans GC)
3) Lymphoid cells
4) Necrosis
5) Fibrosis

14. GIANT CELLS
Features:
Large in size
Contain multiple nuclei(15-30)
Normally seen in:
Osteoclast in bones
Synctiotrophoblast in placenta
Pathologically seen in:
Inflammatory condition
Tumour giant cells in certain neoplasm

15. Types of giant cell
Mcrophages derived giant cells :
1)Langhans giant cells
2)Foreign body giant cells
3)Touton giant cells
4)Aschoff giant cells
Epidermal cell derived giant cells:
1)Tzanck giant cells
2)Multinucleate epidermal giant cells