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Question 375
Pathology → General
Classification
Question
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A biopsy from a persistent inflammatory lesion demonstrates a granuloma containing multinucleated giant cells, surrounding T lymphocytes and a central population of large cells derived from activated macrophages. Which cell type constitutes this central macrophage-derived population?
Question Stem
Select the single best answer.
Options
A
Plasma cells
B
Neutrophils
C
Fibroblasts
D
Epithelioid cells
E
Eosinophils
Explanation
Granulomatous inflammation develops in response to persistent, poorly digestible antigen. Activated macrophages become modified into epithelioid cells, which form the central cellular component of the granuloma and may be accompanied by multinucleated giant cells.
Option Validity
A) Plasma cells may occur in chronic inflammation but are not the characteristic modified macrophages at the centre of a granuloma.
B) Neutrophils predominate in acute inflammatory responses rather than forming the central macrophage-derived population of a granuloma.
C) Fibroblasts contribute to collagen deposition and become more prominent as the granuloma ages but are not modified macrophages.
E) Eosinophils are inflammatory leucocytes but are not the epithelioid macrophage population defining granulomatous inflammation.
Further Reading
Saxena R. Textbook for MRCOG-1. Chapter 5: Pathology. General Pathology, pp.161–175.