Caseous necrosis
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Caseous necrosis describes a form of biological tissue death. The dead tissue appears as a soft and white proteinaceous dead cell mass. Like most patterns of necrosis, no histological architecture is preserved - it is characterised by acellular pink areas of necrosis surrounded by a granulomatous inflammatory process. Invariably, caseous necrosis is associated with tuberculosis (TB).
When the hilar lymph node for instance is infected with tuberculosis and leads to caseous necrosis, it would appear to have a cheesy tan to white appearance, which is why this type of necrosis is often depicted as a combination of both coagulative and liquefactive necrosis.
However, in the lung, extensive caseous necrosis with confluent cheesy tan granulomas is typical. The tissue destruction is so extensive that there are areas of cavitation (also known as cystic spaces).
