A biopsy from a skin lesion in a patient with tertiary syphilis shows granulomatous inflammation with central coagulative necrosis surrounded by epithelioid histiocytes, multinucleated giant cells, and a lymphocytic infiltrate. The necrosis retains some architectural outlines. What is this pattern called?
- A Caseous necrosis
- B Gummatous necrosis ✓
- C Liquefactive necrosis
- D Fat necrosis
Correct answer: B. Gummatous necrosis
Explanation
Gummatous necrosis is the characteristic necrosis of tertiary syphilis. It is coagulative but retains ghost outlines of tissue architecture, unlike caseous necrosis which is amorphous and structureless. Liquefactive necrosis occurs in abscesses and brain infarcts. Fat necrosis occurs in acute pancreatitis and breast trauma. The granulomatous inflammation with giant cells is typical of gummatous syphilis.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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