Editing Gumma (pathology) (section)

==Presentation==
Gummas have a firm, necrotic center surrounded by inflamed tissue, which forms an amorphous proteinaceous mass.  The center may become partly [[hyaline|hyalinized]].
These central regions begin to die through [[coagulative necrosis]], though they also retain some of the structural characteristics of previously normal tissues, enabling a distinction from the granulomas of [[tuberculosis]] where [[caseous necrosis]] obliterates preexisting structures.{{citation needed|date=February 2025}}  Other histological features of gummas include an ''intervening zone'' containing [[epithelium|epithelioid]] cells with indistinct borders and multinucleated [[giant cell]]s, and a ''peripheral zone'' of [[fibroblast]]s and [[capillary|capillaries]].  Infiltration of [[lymphocyte]]s and [[plasma cell]]s can be seen in the peripheral zone as well.  With time, gummas eventually undergo fibrous degeneration, leaving behind an irregular scar or a round fibrous nodule.{{cn|date=April 2021}}

It is restricted to [[necrosis]] involving [[Spirochaete|spirochaetal]] infections that cause [[syphilis]].  Growths that have the appearance of gummas are described as gummatous.<ref>{{cite journal | vauthors = Cui L, Xu Z, Hou H | title = Diagnosis and Treatment of Spinal Syphilitic Gumma: A Case Report | journal = Frontiers in Neurology | volume = 10 | pages = 1352 | date = 2020-01-15 | pmid = 32010040 | pmc = 6974620 | doi = 10.3389/fneur.2019.01352 | doi-access = free }}</ref>