MRCP UK EXAMINATIONS

ABDOMINAL

GENERALISED LYMPHADENOPATHY

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
A histological investigation of the cervical lymph node revealed the aggregation of epithelioid cells, lymphocytes and giant Pirogov-Langhans cells. In the centre of a lesion a caseous necrosis was present. Specify the most likely pathology.
A
Tuberculosis
B
Rhinoscleroma.
C
Sarcoidosis (Boeck’s disease)
D
Syphilis
Explanation: 

Detailed explanation-1: -Tuberculous cervical lymphadenitis is caused by spread of Mycobacterium tuberculosis from a lung infection. Scrofula often presents as a one-sided red, painless mass, located along the upper border of the sternocleidomastoid muscle or in the supraclavicular area or axilla.

Detailed explanation-2: -tb triggers the differentiation of granuloma macrophages into very large multinucleated giant cells (MGCs) that are unable to mediate any bacterial uptake.

Detailed explanation-3: -The most major histological features were giant cell (88%), caseation (84%), epithelioid cells (80%), granuloma and caseation (68%), lymphocytes (31%), and histiocytes (4%).

Detailed explanation-4: -Tuberculosis (TB) is the most common cause of cervical lymphadenopathy in the TB-endemic zone, like India but it can also mimic other diseases.

There is 1 question to complete.