Pathology · Inflammation (Acute, Chronic, Granulomatous, Mediators)

A 22-year-old man with a positive tuberculin skin test develops a cavitary lung lesion. Biopsy shows a granuloma with central amorphous, eosinophilic, necrotic debris. The necrosis is best classified as:

  • A Coagulative necrosis
  • B Liquefactive necrosis
  • C Caseous necrosis
  • D Fibrinoid necrosis
Correct answer: C. Caseous necrosis

Explanation

Caseous necrosis is the hallmark of tuberculosis. It appears as amorphous, granular, eosinophilic debris with loss of cellular outlines, driven by a type IV hypersensitivity response. Coagulative necrosis preserves tissue architecture, liquefactive necrosis is seen in abscesses, and fibrinoid necrosis occurs in vessel walls in immune complex disease.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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