Volume 13 | Issue 1 Article 4

1951 Granulomatous Inflammation of Domestic Mammals R. A. Runnells Michigan State College

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Recommended Citation Runnells, R. A. (1951) "Granulomatous Inflammation of Domestic Mammals," Iowa State University Veterinarian: Vol. 13 : Iss. 1 , Article 4. Available at: https://lib.dr.iastate.edu/iowastate_veterinarian/vol13/iss1/4

This Article is brought to you for free and open access by the Journals at Iowa State University Digital Repository. It has been accepted for inclusion in Iowa State University Veterinarian by an authorized editor of Iowa State University Digital Repository. For more information, please contact [email protected]. Granulomatous Inflammation of Domestic Mammals

R. A. Runnells, D.V.M. M.S. *

HEN you began the study of in­ action. You learned that actinobacillosis, W flamation in your sophomore year actinomycosis, so-called botryomycosis, you were given a detailed description of blastomycosis, porcine brucellosis, coc­ the histopathological changes which occur cidioidomycosis, glanders, histoplasmosis, throughout this defensive reaction of the 30hne's disease, toxoplasmosis, and tu­ body against an irritant. In that intro­ berculosis belong to this group of diseases duction to inflammation you became and that they are caused by micro­ acquainted with the acute non-suppura­ organisms which are either bacteria, tive form of the process. From that first yeasts, molds, fungi or protozoa. description it was easy and logical to go on to a detailed account of the alterations Vascular and exudative changes which occur in the tissues in chronic non­ In the conventional description of in­ suppurative inflammation. After that it flammation emphasis is placed on the vas­ was not difficult to add the special tissue cular and exudative changes. The same reactions which appear in acute and underlying alterations occur in granu­ chronic suppurative inflammation. After lomatous inflammation but the vascular disposing of non-suppurative and sup­ changes are at a minimum and the exu­ parative inflammation there remained a dative changes are characterized by a third type which called for special con­ scant amount of fluid but an excessive sideration. It was granulomatous inflam­ accumulation of inflammatory cells, par­ mation. This type of reaction called for ticularly large mononuclear phagocytes. special handling because it appeared so There is such an extensive accumulation, different from the other two types. and also proliferation of large mononu­ You were soon struck by the fact that clear phagocytes, that there is often a granulomatous inflammation is quite dif­ tendency for nodules of inflammatory ferent from non-suppurative and sup­ tissue to form. These phagocytes, as you purative inflammation. You were also remember, belong to the so-called reticu­ impressed by the fact that several im­ loendothelial system. They are derived portant and usually fatal cbronic diseases both from the blood and tissue spaces. of animals have granulomatous inflam­ There is no complete agreement among mation as the basic histopathological re- histologists as to their origin but three things about them are certain; they are * Editor's note: Dr. Runnells received his D.V.M. phagocytes, they are capable of rather degree from Michigan State College in 1916. He became Associate Professor of Veterinary Path­ rapid proliferation, and they display ology at Iowa State College, and later became metamorphosis. By metamorphosis is Professor of Animal Pathology at Michigan meant the interesting epitheloid nature State College. He wrote the popular textbook, "Animal Pathology." and the multinucleated giant cell forma-

Issue 1, 1951 15 tion which these cells assume in most of and Actinomyces bovis do not stimulate the granulomatous diseases. the formation of as many macrophages but do attract sufficient numbers of neu­ Chronic inflammation trophils so that suppuration occurs. This type of inflammation therefore is not a In all three types of chronic inflamma­ pure granulomatous one but a mixture of tion - non-suppurative, suppurative and granulomatous and suppurative. Staphy­ granulomatous - the same inflammatory lococcus ascoformans, the cause of so­ cellular elements are present, i.e., lym­ called botryomycosis, also causes a mixed phocytes, plasma cells, large mononuclear granulomatous and suppurative inflam­ phagocytes, and neutrophils, but the rela­ mation. tive number and the distribution of each While some diseases like bovine tuber­ kind of cell is entirely different and quite culosis and Johne's disease are character­ characteristic for each type of inflamma­ ized by a pure granulomatous inflamma­ tion. tion and others like actinobacillosis, acti­ In the pure chronic non-suppurative nomycosis, botryomycosis, glanders and inflammation there is a mixture of lym­ porcine brucellosis present a mixture of phocytes and plasma cells with some large the granulomatous and suppurative types, mononuclear phagocytes and few neu­ there is one disease which displays a trophils. In chronic suppurative inflam­ variation of types. The disease is coc­ mation the chief cell of course is the cidioidomycosis caused by the mold Coc­ neutrophil. In the chronic granulomatous cidioides immitis. The variations of types inflammation there is an accumulation of inflammation in this disease are ex­ and proliferation of large mononuclear plained on the basis that the three de­ phagocytes. velopmental stages of this mold in the All three types of inflammation may body incite different inflammatory reac­ progress to the healing stage which con­ tions. sists of a fibrosis followed by scar forma­ tion. In some diseases the centers of the Function of the macrophage granulomatous areas may undergo case­ ation necrosis either with or without cal­ The function of the macrophage in cification, as in porcine brucellosis and granulomatous inflammation is obviously bovine tuberculosis. Later fibrosis and phagocytosis of the invading microorgan­ scar formation, sometimes with hyalini­ ism. The outcome of the attack on the zation, may be the terminal process. In invader however is quite variable; that histoplasmosis of the liver of the dog is, the invader may be phagocytized and there is a distinct coagulation necrosis. destroyed, or after ingestion the invader While the neutrophil is the first cell to may kill the phagocyte, or after engulf­ appear in an area of invasion of the spe­ ing the invader the latter may continue cific agent in granulomatous inflamma­ to live within the phagocyte, an example tion, as in the other two types of inflam­ of a strange type of intracellular para­ mation, the most promient cell and also sitism. In the latter instance the most the most important cell eventually is the peculiar reaction occurs in that the intra­ large mononuclear phagocyte, but the cellular parasite seems to stimulate the response of this cell to the different phagocyte to proliferate, to migrate and causative agents is not exactly the same. undergo metamorphosis. In Johne's di­ Some of the specific irritants such as sease, histoplasmosis, toxoplasmosis, and Mycobacterium tuberculosis and Myco­ coccidioidomycosis in particular one ob­ bacterium paratuberculosis stimulate serves these phenomena. One wonders principally the accumulation and prolif­ how the macrophages can gorge them­ eration of very large numbers of the selves with such large numbers of the large mononuclear phagocytes. Other causative agent and still remain alive. causative agents like Brucella suis, Mal­ Furthermore one wonders why the leomyces mallei~ Actinobacillus lignieresi chronic inflammatory process is not ac-

16 Iowa State College Veterinarian companied by conspicuous connective the hazards of keeping affected animals tissue proliferation. is great. Wherever possible they should The eventual outcome of most cases of be destroyed and autopsied, but the pro­ granulomatous inflammation is death of sector should bear in mind that the the animal. The process kills by displac­ specific agent causing several of these ing tissue in vital organs or by obstructing diseases is transmissible to man. hollow or tubular shaped organs. In this References respect the action of the areas of inflam­ 1. Baker, Roger Denio: Experimental blasto­ mation resembles that of tumors, and in mycosis in mice. Amer. Jour. Path., 18: 463-497 (1942). fact masses of granulomatous tissue are 2. Baker, Roger Denio: Tissue changes in fun­ often referred to as granulomas. Death gous infections. Arch. Path., 44: 459-466 (1947). may be postponed for months or years 3. Brown, Ivan W., Forbus, Wiley D., and however because many of the lesions Kerby, G. P.: The reaction of the reticuloen­ often have a tendency to heal but by dothelial system in experimental and natur­ ally acquired brucellosis of swine. Amer. metastasis the causative agent gradually Jour. Path., 21:205-231 (1945). spreads to other areas in the body. 4. Cannon, Paul R.: Defense mechanisms in in­ fectious and related diseases. Ann. Rev. Diagnosis of granulomatous inflamma­ Physiol., 2:387--410 (1940). tory diseases is often difficult. For the 5. Christiansen, M. J. and Thomsen, Axel: His­ most part there are no distinguishing tologische Untersuchunger liber Brucella .-:luis Infection bei Schweinen. Acta Path. et characteristic symptoms. The course is Microb. Scand. Supp., 18:64--85 (1934). usually long - measured in weeks, 6. Davis, C. L .. Stiles, Geo. W., Jr., and Mc­ months or years. Fever is not constant Gregor, A. N.: Pulmonary coccidioidal gran­ uloma. Jour. Amer. Vet. Med. Assoc., 91: or high unless there is suppuration. There 209-215 (1937). is usually gradual wasting, and progres­ 7. Feldman, William H.: The histology of ex­ sive weakness and anemia. Symptoms perimental tuberculosis in different species. Arch. Path., 6:896--913 (1931). related to obstruction or compression of 8. Foot, Nathan Chandler: The endothelial vital organs may become apparent. Chills phagocyte, a critical review. Anat. Rec., and prostration may occur before death. 30:15-51 (1925). 9. Forbus, Wiley D., and Davis, C. L.: A In some of the diseases characterized chronic granulomatous disease of swine with by granulomatous inflammation sensitiz­ striking resemblance to Hodgkin's disease. Amer. Jour. Path., 22:35--67 (1946). ing antibodies are produced by the lym­ 10. Forbus, Wiley D.: Granulomatous inflamma­ phocytes and reticuloendothelial cells in tion: It's nature, general pathological sig­ sufficienLnumbers to give a reaction to nificance and clinical character. Monograph in American Lectures in Pathology. Charles skin sensitizing tests. This is particularly C. Thomas, Springfield, Illinois (1949). true in tuberculosis, Johne's disease and 11. Hallman, E. T. and Witter, J. F.: Some ob­ glanders. To some extent it is true also servations on the pathology of Johne's di­ sease. Jour. Amer. Vet. Med. Assoc., 36: 159- in coccidioidomycosis and histoplasmosis. 187 (1933). The clinical laboratory can give some 12. Lang, F. J.: Role of endothelium in the pro­ duction of polyblasts (mononuclear wander­ assistance in diagnosis. In histoplasmosis ing cells) in inflammation. Arch. Path., circulating monocytes sometimes contain 1:41-63 (1926). histoplasmae. Examination of pus from 13. Lewis, Warren H.: The transformation of mononuclear blood cells into macrophages, suspected lesions of actinomycosis, acti­ epithelioid cells, and giant cells. Harvey nobacillosis, botryomycosis, porcine bru­ Lectures, 21:77-112 (1925-26). 14. Marsh, Hadleigh: Special report on the his­ cellosis and glanders may reveal the topathology of glanders. Jour. Amer. VeL causative agent. Fecal examination of Med. Assoc., 9:40--47 (1920). suspected Johne's disease cases may be 15. McFadyean, Sir John: Botryomycosis. Jour. Compo Path. and Ther., 32:73-89 (1919). useful. In pets an exploratory abdominal 16. McFadyean, Sir John: Actinomycosis and opening for the purpose of obtaining actinobacillosis. Jour. Compo Path. and Ther., biopsy material or cultures is of value. 45:93-105 (1932). 17. Olafson, P. and Monlux, W. S.: Toxoplasma Treatment of animals having any of infection in animals. Cornell Vet., 32:176--19() the granulomatous diseases listed above (1942) . with the exception of actinobacillosis and 18. Ruhe, Joseph S. and Cazier, Philip D. A re­ view of histoplasmosis. Jour. Amer. Vet. actinomycosis is of little value. In fact Med. Assoc., 115:47-50 (1949).

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