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Question 393
Pathology → General
Classification
Question
SSBAQuestion Header
A biopsy from a persistent inflammatory lesion shows a granuloma containing epithelioid cells and multinucleated giant cells. The centre contains caseous material. Which additional finding most strongly supports tuberculosis as the underlying cause?
Question Stem
Select the single best answer.
Options
A
Langhans giant cells
B
Absence of macrophage-derived cells
C
Predominant acute neutrophilic infiltration without granuloma formation
D
Complete absence of peripheral T lymphocytes
E
A purely transudative inflammatory response
Explanation
Granulomatous inflammation is characterised by modified macrophages forming epithelioid cells, multinucleated giant cells and peripheral T lymphocytes. Tuberculous granulomas may show central caseation and Langhans giant cells.
Option Validity
B) Epithelioid cells are modified macrophages and are central components of granulomatous inflammation.
C) A purely acute neutrophilic infiltrate does not describe the granulomatous architecture in the stem.
D) T lymphocytes are found around granulomas rather than being characteristically absent.
E) Granulomatous inflammation is a cellular chronic inflammatory response and is not defined by a purely transudative process.
Further Reading
Saxena R. Textbook for MRCOG-1. Chapter 5: Pathology. General Pathology, pp.161–175.