Granulation tissue

Granulation tissue
	Diagnosis in short
	; Granulation tissue. H&E stain.
LM	blood vessel rich - key element, proliferation of fibroblasts - key element, inflammation - especially lymphocytes (plasma cells common), +/- evidence of erosion/ulceration
LM DDx	mucocele, traumatized hemangioma, pyogenic granuloma
Gross	granular appearance, erythematous
Site	skin, gastrointestinal tract, other
Clinical history	+/-trauma
Prevalence	common
Prognosis	benign
Treatment	+/-debridement

Granulation tissue forms when wounds heal.

Gross

Looks granular, ergo the name granulation tissue.

Image

Granulation. (WC)

Microscopic

Features:

Blood vessel rich - key element.^[1]
- Small size ~ 25 micrometers in diameter.^{[citation needed]}
Proliferation of fibroblasts - key element.
Inflammation - especially lymphocytes.
- Plasma cells common.

DDx:

Mucocele.
Pyogenic granuloma.
Traumatized hemangioma.
Prolapsed fallopian tube - rare complication following hysterectomy.^[2]

Images

GT. (WC/Patho)
GT. (WC/Patho)
GT. (WC/Patho)

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Submitted as "Granulation Tissue - Vaginal", Excision:
- Granulation tissue, see comment.
- NEGATIVE for epithelium.
- NEGATIVE for evidence of malignancy.

Comment:
Clinical correlation and follow-up is recommended.

Block letters

URINARY BLADDER, BIOPSY:
- REGENERATIVE EPITHELIUM, INFLAMED SUBEPITHELIAL TISSUE AND GRANULATION TISSUE.
- NO MUSCULARIS PROPRIA.
- NEGATIVE FOR MALIGNANCY.

TISSUE, VAGINAL VAULT, BIOPSY:
- GRANULATION TISSUE.
- NEGATIVE FOR FALLOPIAN TUBE.
- NEGATIVE FOR MALIGNANCY.

Micro

The sections show vascular tissue with plump fibroblasts, reactive endothelial cells and a mixed inflammatory infiltrate (granulation tissue). Focally, a dense cluster of neutrophils is seen at the luminal aspect.

A single layer of epithelium with pale, plump nuclei is present without apparent mitotic activity. Inflamed subepithelial tissue is present. No stratified urothelium is identified. No significant nuclear atypia is present.

Alternate

The sections show a polypoid fragment of vascular and edematous tissue with a mixed inflammatory infiltrate consisting of plasma cells, neutrophils and lymphocytes.

No epithelial component is readily identified. No elements of fallopian tube are identified. No significant nuclear atypia is identified.

References

↑ Howdieshell TR, Callaway D, Webb WL, et al. (April 2001). "Antibody neutralization of vascular endothelial growth factor inhibits wound granulation tissue formation". J. Surg. Res. 96 (2): 173–82. doi:10.1006/jsre.2001.6089. PMID 11266270.
↑ Fan, QB.; Liu, ZF.; Lang, JH.; Sun, DW.; Leng, JH.; Zhu, L.; Ning, L. (Mar 2006). "Fallopian tube prolapse following hysterectomy.". Chin Med Sci J 21 (1): 20-3. PMID 16615279.
↑ URL: http://www.siumed.edu/~dking2/intro/inflskin.htm. Accessed on: 17 January 2011.

[pmid11266270-1] Howdieshell TR, Callaway D, Webb WL, et al. (April 2001). "Antibody neutralization of vascular endothelial growth factor inhibits wound granulation tissue formation". J. Surg. Res. 96 (2): 173–82. doi:10.1006/jsre.2001.6089. PMID 11266270.

[2] Fan, QB.; Liu, ZF.; Lang, JH.; Sun, DW.; Leng, JH.; Zhu, L.; Ning, L. (Mar 2006). "Fallopian tube prolapse following hysterectomy.". Chin Med Sci J 21 (1): 20-3. PMID 16615279.

[3] URL: http://www.siumed.edu/~dking2/intro/inflskin.htm. Accessed on: 17 January 2011.

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