Site created by

 Dr Sampurna Roy MD

http://www.histopathology-india.net/dermpath.htm

                       

  Dr  Sampurna Roy  MD

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.   Image Link1 ; Image Link2 ; Image Link3  .

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.

Cerebral gumma mimicking glioblastoma multiforme.
Neurocrit Care. 2005;2(3):300-2.

Syphilitic gumma--cutaneous tertiary syphilis.J Eur Acad Dermatol Venereol. 2004 Jul;18(4):517-8.

A case of cerebral syphilitic gumma. No Shinkei Geka. 2002 Aug;30(8):881-5.

Syphilitic gumma.Trans R Soc Trop Med Hyg. 1996 Sep-Oct;90(5):548-9.

Anticytoplasmic antibodies (cANCA) in syphilitic nodules of the lung. Dtsch Med Wochenschr. 1996;121(19):617-21.

Cerebral gumma mimicking glioblastoma on magnetic resonance images--case report.Neurol Med Chir (Tokyo). 1995 Jul;35(7):462-6