Figure 231

Necrotizing granulomatous inflammation in a wedge biopsy of lung from a patient with Wegener's granulomatosis (hematoxylin and eosin). Note the scattered large multinucleated giant cells on the left side and the extensive necrosis and neutrophilic infiltration on the right side. The granulomatous inflammation of acute Wegener's granulomatosis has much more neutrophilic infiltration and liquefactive necrosis than most other forms of granulomatous inflammation, which is why the lesions in the lung tend to cavitate, and why the lesions in the nose and sinuses tend to destroy bone.

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