Respiratory Pathology Practice Questions

Q: Patient presents with dry cough, dyspnea and stridor. HPE of hilar LN shows stellate granulomas with giant cells and circular lamellated concretions on histopathology. Which of the following is the most likely diagnosis?

Sarcoidosis. ***Sarcoidosis*** - The histopathological finding of **stellate granulomas** (non-caseating) in the lymph node, combined with **circular lamellated concretions** (**Schaumann bodies**), is highly characteristic, if not pathognomonic, of **Sarcoidosis**. - The presentation of hilar lymphadenopathy (inferred from HPE of hilar LN) with dry cough and dyspnea is the most common manifestation of pulmonary sarcoidosis [1]. *Tuberculosis* - **Tuberculosis** typically results in granulomas that display **caseating necrosis** (cheese-like), a feature absent from the description of stellate granulomas. - Although TB causes hilar lymphadenopathy, it does not typically produce **Schaumann bodies** or exhibit the distinct, non-necrotizing stellate granuloma morphology. *GPA* - **Granulomatosis with Polyangiitis (GPA)** is characterized by **necrotizing vasculitis** and widespread **necrotizing granulomatous inflammation** involving the upper and lower respiratory tracts. - GPA granulomas are generally large and necrotizing, and they do not contain the specific organization or inclusion bodies like **Schaumann bodies** seen in sarcoidosis. *Hypersensitivity pneumonitis* - This condition involves scattered, often poorly formed, **non-necrotizing granulomas** typically located in the lung interstitium (centrilobular distribution). - Unlike sarcoidosis, generalized hilar lymph node involvement and the presence of classical **Schaumann bodies** or well-defined stellate granulomas are rare in Hypersensitivity Pneumonitis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lung, pp. 700-701.

Question 1

Alpha-1 antitrypsin deficiency is associated with which type of emphysema?

Accepted Answer

Panacinar emphysema

Answer

Centriacinar emphysema

Answer

Paraseptal emphysema

Answer

Irregular emphysema

Question 2

Ghons focus is typically located in which region?

Accepted Answer

Subpleural caseous lesion in the right upper lobe

Answer

Left apical parenchymal region

Answer

Right apical parenchymal region

Answer

Subpleural caseous lesion in the left upper lobe

Question 3

Paradoxical respiration is seen in which of the following conditions?

Accepted Answer

Diaphragmatic palsy

Answer

Multiple fractured ribs

Answer

Bulbar polio

Answer

Severe asthma

Question 4

A 60-year-old person presents with a mass located at the central bronchus causing distal bronchiectasis and recurrent pneumonia. Which of the following findings is expected from a biopsy of the mass?

Accepted Answer

Small round cells and hyperchromatic nuclei with nuclear moulding

Answer

Abundant osteoid matrix formation

Answer

Contains all three germ layers

Answer

Spindle cells with abundant stromal matrix

Question 5

Lobar pneumonia is caused predominantly by which organism?

Accepted Answer

Streptococcus pneumoniae

Answer

Klebsiella pneumoniae

Answer

Staphylococcus pyogenes

Answer

Haemophilus influenzae

Question 6

Most cases of paraneoplastic syndrome are associated with which type of lung carcinoma?

Accepted Answer

Small Cell Carcinoma

Answer

Bronchogenic Carcinoma

Answer

Bronchoalveolar Carcinoma

Answer

Adenoid Cystic Carcinoma

Question 7

Which drug is used for topical application in respiratory papillomatosis?

Accepted Answer

Cidofovir

Answer

Acyclovir

Answer

Ranitidine

Answer

Ribavirin

Question 8

What is hamartomatous lung tissue?

Accepted Answer

Congenital cystic adenomatoid malformation

Answer

Hypoplasia of lung

Answer

Congenital cyst

Answer

Lobar sequestration

Question 9

Mediastinal lymph node calcification is seen in which one of the following conditions?

Accepted Answer

Sarcoidosis

Answer

Metastatic neoplasm

Answer

Lymphoma

Answer

Bronchiectasis

Question 10

Patient presents with dry cough, dyspnea and stridor. HPE of hilar LN shows stellate granulomas with giant cells and circular lamellated concretions on histopathology. Which of the following is the most likely diagnosis?

Accepted Answer

Sarcoidosis

Answer

GPA

Answer

Hypersensitivity pneumonitis

Answer

Tuberculosis

Respiratory Pathology — MCQs

Respiratory Pathology — MCQs

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