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After a few weeks, T cell-mediated immunity develops and leads to activation of macrophages so they can kill intracellular mycobacteria via reactive nitrogen intermediates. This process leads to formation of epithelioid cell granulomas and clearance of the mycobacteria. Also, CD8+ suppresser T cells kill macrophages that are infected with mycobacteria, resulting in the formation of caseating granulomas. These processes during the primary infection with M. tuberculosis result in a calcified scar in the lung parenchyma and in the hilar lymph node. This combination is called the Ghon complex.
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== Additional Resources ==
=== Reference ===
* [http://emedicine.medscape.com/article/230802-overview eMedicine Medical Library: Tuberculosis]
* [http://www.merckmanuals.com/professional/infectious_diseases/mycobacteria/tuberculosis_tb.html Merck Manual: Tuberculosis (TB)]
=== Journal Articles ===
* Rodrigues DS, Medeiros EA, Weckx LY, Bonnez W, Salomão R, Kallas EG. [http://www.ncbi.nlm.nih.gov/pubmed/11982602 Immunophenotypic characterization of peripheral T lymphocytes in Mycobacterium tuberculosis infection and disease]. ''Clin Exp Immunol'' 2002 Apr;128(1):149-54.
=== Images ===
* [http://peir.path.uab.edu/library/index.php?/tags/259-tuberculosis PEIR Digital Library: Tuberculosis Images]
* [http://library.med.utah.edu/WebPath/LUNGHTML/LUNGIDX.html#4 WebPath: Granulomatous Diseases]
== Related IPLab Cases ==
* [[IPLab:Lab 1:Tuberculosis|Lab 1: Lung: Tuberculosis (Caseous Necrosis)]]
* [[IPLab:Lab 3:Tuberculosis|Lab 3: Lung: Tuberculosis]]
{{IPLab 6}}
[[Category: IPLab:Lab 6]]
