What is the Difference Between Granulomatous and Nongranulomatous Inflammation

The key difference between granulomatous and nongranulomatous inflammation is that in granulomatous inflammation, epithelial and giant cell formation takes place, while in nongranulomatous inflammation, there is no formation of epithelial and giant cells.

Inflammation is a response of the immune system to pathogens, toxic compounds, damaged cells, and irradiation. Therefore, it is a defense mechanism that is vital to health. At the level of tissues, inflammation is characterized by swelling, redness, pain, and loss of function. Major microcirculatory events that take place during the inflammatory process are vascular permeability changes, recruitment of leukocytes and accumulation, and inflammatory mediator releases. Granulomatous and non-granulomatous inflammations are two types of inflammatory reactions. They mainly use white blood cells to help the body to fight infections.

CONTENTS

1. Overview and Key Difference
2. What is Granulomatous Inflammation
3. What is Nongranulomatous Inflammation
4. Similarities – Granulomatous and Nongranulomatous Inflammation
5. Granulomatous vs Nongranulomatous Inflammation in Tabular Form
6. Summary – Granulomatous vs Nongranulomatous Inflammation

What is Granulomatous Inflammation?

Granulomatous inflammation is a special type of chronic inflammation where the mononuclear phagocyte is predominant and takes the form of macrophages, multinucleated giant cells, and epithelial cells. These cells aggregate into focal lesions called granulomas. This type of inflammation is found in many infective, allergic, toxic, autoimmune, and neoplastic diseases. Granuloma formation takes place as a defense mechanism for irritants of exogenous or endogenous origin.

During this process, the causative agent is separated and isolated by macrophage cells. Two groups carry out the recruitment and localization of monocytes into the lesions. The emigration from circulation is promoted by chemotactic agents, which include microbial products, fibrin degradation, complement components, and lymphokines. Meanwhile, macrophages’ immobilization within the lesion occurs due to lymphokines and macrophage adhesion factors. The fusion of macrophages forms multinucleated giant cells. It is an immune-mediated phenomenon, and lymphokines stimulate giant cell production. Epithelioid cells are mononuclear cells with granular eosinophilic cytoplasm, vesicular nuclei, and cell boundaries found aggregated into clusters within the granuloma. Epithelioid cells are a part of cell-mediated immunity and play an important role in delayed hypersensitivity. There are two types of granulomas; the are foreign-body granulomas and epithelioid or hypersensitivity granulomas.

What is Nongranulomatous Inflammation?

A non-granulomatous inflammation is an acute and purulent inflammatory reaction where the predominant cell type is polymorphonuclear leukocyte. This type of reaction does not contain epithelial or multinucleated giant cells. This type of inflammation is characterized by the formation of pus and usually has an acute onset. It is also considered a secondary infection with bacteria such as Staphylococcus aureus, which forms pus as an anti-inflammatory reaction.

If a single tissue is involved in the inflammation, it is classified according to the tissue involved. If more than one tissue is involved, the inflammation is classified by the tissues involved with the site of primary involvement. Sources of non-granulomatous inflammation are exogenous and endogenous. This type of inflammation is common in the eye and is called uveitis. The indications are acute onset, pain in the eye, sensitivity to light, and pus formation.

What are the Similarities Between Granulomatous and Nongranulomatous Inflammation?

• Granulomatous and nongranulomatous inflammation are inflammatory reactions that take place in the immune system.
• They have a predominant cell type in the reaction.
• Both are caused due to exogenous and endogenous sources.
• Moreover, both contain white blood cells.

What is the Difference Between Granulomatous and Nongranulomatous Inflammation?

Granulomatous inflammation involves epithelial and giant cell formation, while nongranulomatous inflammation does not involve the formation of epithelial and giant cells. Thus, this is the key difference between granulomatous and nongranulomatous inflammation. Granulomatous inflammation is a chronic inflammation, while non-granulomatous inflammation is an acute and purulent inflammatory reaction. Granulomatous inflammation is an organismal invasion with moderate inflammatory activity, while non-granulomatous inflammation is an antigen-antibody reaction with severe inflammatory activity.

The below infographic presents the differences between granulomatous and nongranulomatous inflammation in tabular form for side-by-side comparison.

Summary – Granulomatous vs Nongranulomatous Inflammation

Granulomatous and non-granulomatous inflammation are two types of inflammatory reactions. In granulomatous inflammation, epithelial and giant cell formation takes place, while in nongranulomatous inflammation, there is no formation of epithelial and giant cells. Granulomatous inflammation is a special type of chronic inflammation where the mononuclear phagocyte is predominant and takes the form of macrophages, multinucleated giant cells, and epithelial cells. They occur during the invasion of an organism. A nongranulomatous inflammation is an acute and purulent inflammatory reaction where the predominant cell type is polymorphonuclear leukocyte. This type of reaction does not contain epithelial or multinucleated giant cells. It is a severe type of reaction and is considered a secondary reaction with bacteria. So, this summarizes the difference between granulomatous and nongranulomatous inflammation.

Reference:

1. Brito, T. de, and M. F. Franco. “Granulomatous Inflammation.” Revista Do Instituto De Medicina Tropical De São Paulo, Instituto De Medicina Tropical De São Paulo.
2. “Nongranulomatous Inflammation.” Clinical Gate.

Image Courtesy:

1. “Granuloma mac” By Sanjay Mukhopadhyay – Syracuse, NY (Public Domain) via Commons Wikimedia