S11C21P16-Actinomycosis

S11C21P16-1: A granule of a lesion of actinomycosis is represented. Neutrophils are collected at the periphery of, and in a central defect in, the granule. Green arrows point to a bright red condensation at the periphery of the granule (Splendore-Hoeppli phenomena ); the deposit is expressive of the products of a host-immune repsonse; it includes fibrin and immunoglobulins.

S11C21P16-2: The radially arranged clubs of the Splendore-Hoeppli phenomena are represented to the right (green arrows). In the zone of pallor (blue arrows), filamentous organisms are loosely spaced. To the left, the section is denser and the filamentous organisms are basophilic ( actinomycosis). The absence of basophilia in the pale zone may be evidence that the organisms are dead.

S11C21P16-3: At the periphery of this granule from a lesion of actinomycosis, the Splendore-Hoeppli phenomena is spotty in distribution; it is not prominent.

S11C21P16-4: With this special stain, filamentous organisms of a lesion of actinomycosis are blue; they extend from the right into the central red zone. The blue deposit to the left is interpreted as the Splendore-Hoeppli phenomena.

S11C21P16-5: In this lesion of actinomycosis, sinus tracts are irregularly spaced in inflamed, organizing fibrous tissue. Green arrow identifies a colony.

S11C21P16-6: At higher magnification and with this Gram stain, the colony of organisms floats in a sea of pus. Splendore-Hoeppli phenomena are manifested at the margin of the colony.

S11C21P16-7: In this lesion of nocardiosis, there are diffuse and interstitial infiltrates of inflammatory cells. The diffuse zones are areas of suppuration. The inflammation extends into the subcutaneous fat.

S11C21P16-8: The suppurative process extends into the subcutaneous fat. Colonies of organisms are not a feature.

S11C21P16-9: The infiltrates are composed of neutrophils. There is destruction of tissue (suppuration). Vessels have swollen endothelium (nocardiosis). There are focal, poorly organized collections of histiocytes.

 

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