In most cases, the center of this focus undergoes caseous necrosis.

To the naked eye, this has the texture of soft, white cheese and is termed caseous necrosis.

Caseous necrosis is a form of cell death in which the tissue maintains a cheese-like appearance.

Frequently, caseous necrosis is encountered in the foci of tuberculous infections.

In caseous necrosis no histological architecture is preserved.

Caseous necrosis in T.B. is most common site of dystrophic calcification.

However, in the lung, extensive caseous necrosis with confluent cheesy tan granulomas is typical.

Granulomatous tubercules eventually develop central caseous necrosis and tend to become confluent, replacing the lymphoid tissue.

Caseous necrosis can be considered a combination of coagulative and liquefactive necroses, typically caused by mycobacteria (e.g. tuberculosis), fungi and some foreign substances.

Now his right arm was suppurating with tubercular osteitis, and he coughed blood (after his death, his lungs were found to have extensive cavities and caseous necrosis).

The classical histologic pattern of scrofula features caseating granulomas with central acellular necrosis (caseous necrosis) surrounded by granulomatous inflammation with multinucleated giant cells.

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.

When the hilar lymph node for instance is infected with tuberculosis and leads to caseous necrosis, its gross appearance can be a cheesy tan to white, which is why this type of necrosis is often depicted as a combination of both coagulative and liquefactive necrosis.