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The gumma, a characteristic lesion of
tertiary syphilis, may form in any organ or tissue.
Visit: Pathology
of Syphilis ;
Neurosyphilis
;
Bejel
;
Yaws
;
Congenital Syphilis.
This fibrotic and granulomatous lesion
usually presents as an expanding tumour, commonly in the liver and
testis.
In the liver, there may be a solitary
gumma, several large gummas, or widespread small gummas that resembles
cirrhosis.
Gummas of the testis cause diffuse
interstitial fibrosis and contraction of the testis into a round, hard
mass.
Microscopically, gummas are characterized
by a central area of coagulative necrosis, surrounded by epithelioid
cells, occasional giant cells, occasional giant cells, and a perimeter
of fibrous tissue.
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.
The small vessels surrounding the gumma
have thick walls and narrow lumens and resemble the vasa vasorum of
luetic aortitis.
Although infrequently seen, spirochetes
are present in the necrotic centers of gummas. |