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January 27, 1940


JAMA. 1940;114(4):291-296. doi:10.1001/jama.1940.02810040001001

Granulomas are circumscribed masses of granulation tissue formed in the course of the productive phase of inflammation. They may appear on the surface of ulcerations and in the wall of ulcers or may form in any area of tissue destruction with disturbed or incomplete regeneration. Granulomas are composed histologically of newly formed capillaries, fibroblasts, histiocytes and the cells of inflammatory exudates, and they vary in their microscopic pattern according to the infectious agent, the duration of the infection and the reactivity of the diseased organism. Granuloma and chronic inflammation are not completely synonymous processes, although they often appear intimately linked with each other (Lubarsch1). They are most logically classified according to their etiologic factor, which in the majority of cases is an infectious agent. These infectious granulomas then can be differentiated according to the various types of organism, a distinction which is easy for some infections and difficult or

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