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  #1  
Old 07-19-2011
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Microscope Right apical infiltrate with beginning cavitation

The accompanying figure is representative of the findings in a hilar lymph node from a 54-year-old man who sought medical care for low-grade fever, anorexia, fatigue, night sweats, weight loss, and persistent cough with bouts of hemoptysis. A chest X-ray had revealed a right apical infiltrate with beginning cavitation, and examination of the sputum had revealed acid-fast bacilli. This condition is typified by a form of inflammation that invariably includes which of the following?

Right apical infiltrate with beginning cavitation-question.jpg
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(A) A morphologically identifiable etiologic agent
(B) Caseous necrosis
(C) Clusters of epithelioid cells
(D) Multinucleated giant cells
(E) Prominent granulation tissue
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Old 07-19-2011
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Here above features indicate TB...But it is asking invariably so it means which remain constant feature to lesion so it would be D...multinucleated giant cells. Since other things are changes incorporating at various stages of lesion so i go with D.
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Old 07-19-2011
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yeah id think the answer is d too. points towards TB.
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I think it is caseous necrosis
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i think its B. Caseous necrosis.
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Old 07-19-2011
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(B) Caseous necrosis
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I think its D.
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Default Ans E

My choice is E) as TB is Chronic inflammation which is characterized by prominent granulation tissue
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I'll Go with B, its the only i think is goes exclusively with TB. Other's can be seem in Sarcoidosis, Histocytosis, And others Bacterial infections...
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Correct Answer correct answer

The answer is C.

The clinical description and the figure are both typical of advanced secondary tuberculosis. Although this disorder is now relatively uncommon, its incidence is increasing, especially in association with immunodeficiency.
Tuberculosis is a classic cause of granulomatous inflammation, which is characterized by the presence of "granulomas," which by definition consist of clusters of modified macrophages referred to as epithelioid cells. Additional features such as caseous necrosis, giant cell formation, and identifiable etiologic agents may or may not be present and are not invariable features of this form of inflammation. Granulation tissue is a feature of early repair and is totally unrelated to granulomatous inflammation.
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  #11  
Old 07-19-2011
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Quote:
Originally Posted by bebix View Post
The answer is C.

The clinical description and the figure are both typical of advanced secondary tuberculosis. Although this disorder is now relatively uncommon, its incidence is increasing, especially in association with immunodeficiency.
Tuberculosis is a classic cause of granulomatous inflammation, which is characterized by the presence of "granulomas," which by definition consist of clusters of modified macrophages referred to as epithelioid cells. Additional features such as caseous necrosis, giant cell formation, and identifiable etiologic agents may or may not be present and are not invariable features of this form of inflammation. Granulation tissue is a feature of early repair and is totally unrelated to granulomatous inflammation.
Nice question, i though we will found "granulation tissue if it were TB Meningitis... "
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Default granulation tissue is differrent from granuloma

Quote:
Originally Posted by jahn77 View Post
My choice is E) as TB is Chronic inflammation which is characterized by prominent granulation tissue
granulation tissue is differrent from granuloma
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