| Gumma (pathology) | |
|---|---|
 | |
| Gumma of nose due to a long-standing tertiary syphilitic infection. | |
| Specialty | Infectious diseases  |
Agumma (pluralgummata orgummas) is a soft, non-cancerous growth resulting from the tertiary stage ofsyphilis (andyaws[1]).
It is a form ofgranuloma.[2] Gummas are most commonly found in theliver (gumma hepatis), but can also be found in brain, heart, skin, bone, testis, and other tissues, leading to a variety of potential problems includingneurological disorders orheart valve disease.
Gummas have a firm, necrotic center surrounded by inflamed tissue, which forms an amorphous proteinaceous mass. The center may become partlyhyalinized.These central regions begin to die throughcoagulative necrosis, though they also retain some of the structural characteristics of previously normal tissues, enabling a distinction from the granulomas oftuberculosis wherecaseous necrosis obliterates preexisting structures.[citation needed] Other histological features of gummas include anintervening zone containingepithelioid cells with indistinct borders and multinucleatedgiant cells, and aperipheral zone offibroblasts andcapillaries. Infiltration oflymphocytes andplasma cells can be seen in the peripheral zone as well. With time, gummas eventually undergo fibrous degeneration, leaving behind an irregular scar or a round fibrous nodule.[citation needed]
It is restricted tonecrosis involvingspirochaetal infections that causesyphilis. Growths that have the appearance of gummas are described as gummatous.[3]
In syphilis, the gumma is caused by a reaction to spirochaete bacteria in the tissue.It appears to be the human body's way to slow down the action of this bacteria; it is a unique immune response that develops in humans after the immune system fails to kill off syphilis.[citation needed]
The formation of gummata is rare in developed countries, but common in areas that lack adequate medical treatment.[citation needed]
Syphilitic gummas are found in most but not all cases of tertiary syphilis, and can occur either singly or in groups. Gummatous lesions are usually associated with long-term syphilitic infection; however, such lesions can also be a symptom of benign late syphilis.[citation needed]