Scientific Journal Vol. I - 2007 Granulomatous Diseases of the Oral tissues- An etiology & Histopathology Swati Gotmare 1 , Avinash Tamgadge 2 , Sudhir Bhalerao 3 , T. Pareira 4 , Sandhya Tamgadge 5 Abstract Granulomatous inflammation represents a unique form of the chronic inflammatory response Granulomatous diseases of the oral soft & hard tissues is an uncommon occurrence but when found it presents as a definite diagnostic dilemma because of the wide variety of possible etiologic diseases & rather generic appearance of the individual lesions. This article highlights the etiology & histopathological features of granulomatous diseases of the oral tissues. Key words: Granulomatous inflammation, Granulomatous diseases. Introduction A granuloma is a distinct, compact microscopic structure composed of epithelioid – shaped macrophages typically surrounded by a rim of lymphocytes. Fibroblasts & collagen fibers are also seen immediately surrounding the lymphocytes. The epitheol macrophages represent activated cells that on coalesing produce multinucleated giant cells. The nuclei in these giant cells may be arranged either haphazardly (Foreign body-type) or peripherally often in the shape of a horseshoe (Langhans type). In some instances, granuloma also may exhibit a central area of caseous necrosis 2 . Granulomatous inflammation represents a unique form of the chronic inflammatory response. The term granulomatous diseases include those conditions characterized by histological presence Lecturer 1 ,Professor & HOD 2 &, professor 3 , Professor 4 Professor 5 , Dept. of Oral Pathology and Microbiology. Dr D.Y.Patil Dental College and Hospital,Nerul, Navi Mumbai of granuloma resembling those of tuberculosis as well as condition without microscopic granuloma formation but with prominent proliferation of granulation tissue 1 . Granulomatous diseases have plagued humans for million years, with evidence of tuberculosis infection in Egyptians mummies & description of the syphilis has also been said to have been described by Hippocrates & was recognized as a venereal disease in the fifteenth century. In seventeenth century, the minute granules (milliary) in host tissues were noted. Robert koch developed a method of staining & identified bacteria & was able to differentiate infectious, noninfectious granulomatous diseases. Actinomycosis was isolated in vivo & associated with sulfur granule production in the late nineteenth century. The advent of modern pathology with improved microscopic staining techniques & communication between researches spawned this new category of Granulomatous diseases in early twentieth century.