Answer of Dermatopathology Case 104

Allergic Granulomatosis (Churg-Strauss Syndrome)

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The three major microscopic features of Allergic Granulomatosis are:
1) Necrotizing vasculitis
2) Tissue infiltration by eosinophils
3) Extravascular granulomas
It should be noted that the 3 features mentioned above do not always coexist.

In Case No 104 there is small-vessel necrotizing vasculitis together with extensive tissue infiltration by eosinophils. No granulomas were present in the multiple sections taken. Hence in this case detailed clinical history played a very important role to reach the final diagnosis.

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