MRCP UK EXAMINATIONS

ABDOMINAL

GENERALISED LYMPHADENOPATHY

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
A post-mortem of a 58-year-old patient, with a history of tuberculosis, revealed in the upper lobe of the right lung a cavity, 3x2cm in sizes, which connected with a bronchus. A cavity had dense walls and three layers. The internal layer was pyogenic; the middle one was presented with tubercular granulation tissue and the external coating of connective tissue. What of the listed diagnoses the most likely?
A
Fibrocavernous tuberculosis
B
Fibrous focal tuberculosis
C
Tuberculoma.
D
Acute focal tuberculosis
Explanation: 

Detailed explanation-1: -Post-primary TB does not involve lymph nodes or other organs and, hence, is typically confined to the lungs, developing either in the apical or the posterior regions of the upper lobes (83% to 85%)-since these areas are highly oxygenated, promoting proliferation and allowing M.

Detailed explanation-2: -Postprimary tuberculosis, the most common form in adults, typically involves the apices of the upper lobes, producing granulomatous lesions with greater caseation, often with cavities and variable degrees of fibrosis and retraction of the parenchyma.

Detailed explanation-3: -TB can be divided into primary, progressive-primary, and postprimary forms on the basis of the natural history of the disease. Postprimary TB results from either reactivation of a latent primary infection or, less commonly, from the repeat infection of a previously sensitized host.

Detailed explanation-4: -An unusual complication of primary tuberculosis is bronchial obstruction due to pressure of a node on a main bronchus. This phenomenon, sometimes called epituberculosis, may lead to secondary bronchiectasis. Untreated primary disease may progress to involve the entire lung and disseminate.

There is 1 question to complete.