KROK 1 2021 – Question 56 · KROK (Medicine) · Pathomorphology
A 40-year-old man has died of a pulmonary hemorrhage. In the upper lobe of the right lung, autopsy shows a cavity 4 cm in diameter with dense walls and uneven inner surface. The cavity contains blood clots. Microscopy detects disintegrating leukocytes in the inner layer of the cavity wall and proliferations of epithelioid, lymphoid, and giant multinucleated cells with horseshoe-shaped nuclei in the middle layer of the cavity wall. The observed changes in the lung are characteristic of a:
- A. Tuberculous cavity
- B. Pulmonary infarction with septic breakdown
- C. Congenital cyst
- D. Bronchiectatic cavity
- E. Lung abscess
Hint
Look at the layered cavity wall: epithelioid cells, lymphocytes and giant cells with a horseshoe arrangement of nuclei point to a specific granulomatous infection of the upper lobe.
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