This document discusses chronic inflammation and granulomatous inflammation. It defines chronic inflammation as a prolonged inflammatory response involving progressive changes in cell types. Common causes include infection, injury, or autoimmune disorders. Key cell types involved are macrophages, lymphocytes, and plasma cells. Granulomatous inflammation is a type of chronic inflammation characterized by the formation of granulomas, which are aggregates of macrophages surrounded by lymphocytes. Giant cells can form via the fusion of macrophages or other cells. The document describes several subtypes of giant cells seen in specific conditions.

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RUCHIKA DHIMAN
GROUP-5

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● CHRONIC INFLAMMATION
● CAUSES OF CRONIC INFLAMMATION
● TYPES OF CELLS INVOLVED
● GRANULOMATOUS INFLAMMATION
● SUBTYPES OF GIANT CELLS

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Chronic inflammation
 Chronic inflammation refers to a prolonged inflammatory response that
involves a progressive change in the type of cells present at the site of
inflammation. It is characterized by the simultaneous destruction and
repair of the tissue from the inflammatory process. It can follow an acute
form of inflammation or be a prolonged low-grade form.
 Characterised by the microscopic appearances.
 Most important characteristic is the type of cell present.
 Tissue destruction is the hallmark of chronic inflammation.

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Causes of chronic inflammation
 infection or injury
 Autoimmune disorder
 long-term exposure to irritants, such as
industrial chemicals or polluted air.

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Types of cells involved:
● Macrophages -derived from monocytes, Phagocytosis and
destruction of debris & bacteria and several other functions.
● Lymphocytes- Sometimes called ‘chronic inflammatory cells’
● Plasma cells-Differentiated antibody-producing B lymphocytes.
Implies considerable chronicity.
● Eosinophills- Allergic reactions, metazol infestations, some
tumours.

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GRANULOMATOUS INFLAMMATION
● IT IS A TYPE OF CHRONIC INFLAMMATION characterised by formation
of granuloma.
● Granuloma is an aggregation of macrophages surrounded by a collar of
mononuclear cells principally lymphocytes.
● Macrophages may get activated to form epitheliod cells (epithelium like
cells).
● Some of the cells may fuse together to form a bigger cells called a giant
cell.

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The giant cells can be of primarily of following
types:
• Langhans giant cells
• Foreign body giant cells
• Touton giant cells
• Warthin finkledey cells
• Owl eye appearance cells

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Langhans cells
• Nuclei is in
periphery
• horse shoe
pattern
• Seen in
tuberculosis

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• Nuclei in
haphazard
pattern
• Seen in non-
absorbable
sutures
Foreign body giant
cells

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TOUTON CELL
● Nuclei present
● Fatty droplets
present giving
foamy
appearance
● Seen in xanthoma
patients

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Warthin finkeldey cell
• Intra viral inclusions
present
• Seen in viral
infections- measles

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OwlEye Appearance
cell/Reed Sternberg cell
• Two prominent
nuclei like mirror
images of each
other showing owl
eye
• Reed Sternberg
cell seen in
hodgkins
lymphoma

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