Pathology of Syphilitic Gumma

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.  

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.

Syphilitic gumma--cutaneous tertiary syphilis.

A case of cerebral syphilitic gumma.  

Syphilitic gumma.

Anticytoplasmic antibodies (cANCA) in syphilitic nodules of the lung.

Cerebral gumma mimicking glioblastoma on magnetic resonance images--case report.