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Causes of Pyogenic Granuloma. A pyogenic granuloma often occurs in areas of previous trauma including acne cysts. It is believed that this lesion is formed when capillary blood vessels start growing rapidly in response to trauma to the skin. These growths mostly occur after injuries, but the reason for this isnât known.
Note the presence of giant cells. The granulomatous lesions in this disorder are typically non-caseating. This is in constrast to TB granuloma which causes casating granuloma (slides with TB granuloma is uncommon in MRCOphth). A TB granuloma showing central necrosis (caseating granuloma) and the presence of giant cells.n addition, the macrophages may fuse together to form multinucleate giant cells (different types of inciting materials may produce different giant cells). Granulomatous lesion typically occurs when the usual acute inflammatory reaction involving neutrophils could not remove the inciting agent.