Histological examination of a skin tissue sampling revealed granulomas consisting of macrophagal nodules with lymphocytes and plasmatic cells. There are also some big macrophages with fatty vacuoles containing causative agents of a disease packed up in form of spheres (Virchow's cells). Granulation tissue is well vascularized. What disease is this granuloma typical for?

Answer options

1. Rhinoscleroma
2. Glanders
3. Lepra
4. Tuberculosis
5. Syphilis

Explanation

Microscopic examination of specific granulomas: In leprosy (Lepra), the epidermis contains confluent granulomas composed of macrophages, plasma cells, and leprous Virchow's cells. In Rhinoscleroma of the nose is characterized by the presence of scleroma (plasma cells, epithelioid cells, lymphocytes, hyaline sphere) and Mikulicz's cells. In tuberculosis, it is characterized by the presence of central necrosis surrounded by epithelioid cells, lymphocytes, plasma cells, and giant langhance cells. Syphilis granuloma is called Gumma which consists of a central area of fibrinoid or caseous necrosis surrounded by mononuclear inflammatory cells.