Pulmonary granulomatosis Necrotizing pulmonary granulomatosis 2021-01-22T12:12:26Z In hematoxylin and eosin stain staining, necrotizing pulmonary granulomatosis is characterized by acellular pink areas of necrosis surrounded by a granulomatous inflammatory process. Caseating pulmonary granulomatosis A granuloma that is associated with necrotic changes. Caseation necrosis is defined as a region in granulomas with eosinophilic, granular and cheese-like cellular debris with necrosis. The word caseous itself means pertaining or related to cheese, and comes from the Latin word caseus, meaning cheese.