©Elsevier2005 8.A43-year- A transbronchial lung biopsy is performed,yielding a specimen with the microscopic appearance shown.What type of inflammation is this? A.Acute B.Chronic C.Fibrotic D.Granulomatous E.Necrotic Ans:D The specimen shows a central area of (pink)necrosis and lack ofcell nuclei.surrounded by nt cells with oplasm.In the ntext of the c is a caused by infection with bacteriu rculosis.Acute na and ma cells an answer granulomalous injlammation is a more specific answer 9.A 30-year-old woman with a history of a congenital ventricular septal defect has had a persistent temperature of 38.6C and headache for the past 3 weeks.A head CT scan shows an enhancing 3-cm ring like lesion in the right parietal lobe,which the radiologist feels is most .5 - 5 - 8. A 43-year-old man has had a cough and fever for the past 2 months. A chest radiograph shows bilateral nodular densities, some with calcification, located mainly in the upper lobes of the lungs. A transbronchial lung biopsy is performed, yielding a specimen with the microscopic appearance shown. What type of inflammation is this? A. Acute B. Chronic C. Fibrotic D. Granulomatous E. Necrotic Ans: D The specimen shows a central area of (pink) necrosis and lack of cell nuclei, surrounded by several multinucleated giant cells with abundant pink cytoplasm. In the context of the case, this is likely a caseating granuloma caused by infection with Mycobacterium tuberculosis. Acute inflammation would show edema and numerous neutrophils, not granuloma formation. Chronic inflammation is characterized by proliferation of macrophages, lymphocytes, plasma cells, and fibroblasts. There is necrosis in the center of this granuloma (cellular debris without nuclei), but answer granulomatous inflammation is a more specific answer. 9. A 30-year-old woman with a history of a congenital ventricular septal defect has had a persistent temperature of 38.6 o C and headache for the past 3 weeks. A head CT scan shows an enhancing 3-cm ring like lesion in the right parietal lobe, which the radiologist feels is most