Granulation tissue

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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

Microscopic

Features:

  • Blood vessel rich - key element.[1]
  • Proliferation of fibroblasts - key element.
  • Inflammation - especially lymphocytes.

DDx:

Images

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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.

See also

References

  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.