Editing Gumma (pathology)

{{short description|Soft, non-cancerous growth resulting from the tertiary stage of syphilis}}
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| image           = Gumma of nose due to a long standing tertiary syphilitic Treponema pallidum infection 5330 lores.jpg
| caption         = Gumma of nose due to a long-standing tertiary syphilitic infection.
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[[File:Gummata hepatis.jpg|thumb|right|Hepatic gumma]]
[[File:Wachsmoulage einer Gumma bei Siphilis.JPG|thumb|[[Moulage]] of a gumma in [[syphilis]] for training students. [[University of Tübingen]].]]
A '''gumma''' (plural '''gummata''' or '''gummas''') is a soft, non-cancerous growth resulting from the tertiary stage of [[syphilis]] (and [[yaws]]<ref>{{cite journal | vauthors = Marks M | title = Advances in the Treatment of Yaws | journal = Tropical Medicine and Infectious Disease | volume = 3 | issue = 3 | pages = 92 | date = August 2018 | pmid = 30274488 | pmc = 6161241 | doi = 10.3390/tropicalmed3030092 | doi-access = free }}</ref>). 

It is a form of [[granuloma]].<ref name=Goldman2020>{{cite book |last1=Ghanem|first1=Khalil G.|last2=Hook|first2=Edward W.|editor1-last=Goldman |editor1-first=Lee |editor2-last=Schafer |editor2-first=Andrew I. |title=[[Goldman-Cecil Medicine]] |date=2020 |publisher=Elsevier |location=Philadelphia|isbn=978-0-323-55087-1 |page=1985|edition=26th|volume=2 |chapter-url=https://books.google.com/books?id=7pKqDwAAQBAJ&pg=PA1985 |language=en |chapter=303. Syphilis}}</ref> Gummas are most commonly found in the [[liver]] (''gumma hepatis''), but can also be found in brain, heart, skin, bone, testis, and other tissues, leading to a variety of potential problems including [[neurology|neurological]] disorders or [[heart valve]] disease.

==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>

== Pathology ==
In syphilis, the gumma is caused by a reaction to spirochaete bacteria in the tissue.
It appears to be the human body's way to slow down the action of this bacteria; it is a unique immune response that develops in humans after the immune system fails to kill off syphilis.{{cn|date=April 2021}}

== Epidemiology ==
The formation of gummata is rare in developed countries, but common in areas that lack adequate medical treatment.{{cn|date=April 2021}}

Syphilitic gummas are found in most but not all cases of tertiary syphilis, and can occur either singly or in groups.  Gummatous lesions are usually associated with long-term syphilitic infection; however, such lesions can also be a symptom of benign late syphilis.{{cn|date=April 2021}}
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== References ==
{{Reflist}}

== External links ==
<div style="float:left;">{{Medical resources
|   DiseasesDB     = 30601
|   ICD10          = {{ICD10|A|52|3|a|50}} {{ICD10|A|52|7|a|50}}
|   ICD9           = {{ICD9|090.5}} {{ICD9|094.9}} {{ICD9|095}} {{ICD9|102.6}}
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|   MedlinePlus    = 000859
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{{DEFAULTSORT:Gumma (Pathology)}}
[[Category:Histopathology]]
[[Category:Sexually transmitted diseases and infections]]
[[Category:Necrosis]]
[[Category:Syphilis]]