Question 1

Q: A 31 year-old African-American female presents with painful shin nodules, uveitis, and calcified hilar lymph nodes. A transbronchial biopsy of the lung would most likely show which of the following histologies?

Non-caseating granulomas. ***Non-caseating granulomas*** - The constellation of **erythema nodosum** (painful shin nodules), **uveitis**, and **hilar lymphadenopathy** in an African-American female is highly characteristic of **sarcoidosis**. - **Sarcoidosis** is pathologically defined by the presence of **non-caseating granulomas** in affected tissues, which would be visible on a transbronchial biopsy. *Golden-brown fusiform rods* - These are **ferruginous bodies**, characteristic of **asbestosis**, which is not supported by the patient's presentation. - Asbestosis would typically involve a history of **asbestos exposure** and present with **pleural plaques** or **interstitial fibrosis**. *Inflammation, fibrosis and cyst formation that is most prominent in subpleural regions* - This description is more indicative of **pulmonary Langerhans cell histiocytosis**, a rare disease usually associated with **smoking**. - It does not align with the patient's specific systemic manifestations like uveitis or erythema nodosum. *Silica particles (birefringent) surrounded by collagen* - This describes the histological findings of **silicosis**, an occupational lung disease resulting from exposure to **silica dust**. - Silicosis is not typically associated with uveitis or erythema nodosum. *Patchy interstitial lymphoid infiltrate into walls of alveolar units* - This pattern can be seen in various interstitial lung diseases, but it is not specific for sarcoidosis. - It could be found in conditions like **lymphoid interstitial pneumonia**, which does not fit the overall clinical picture.

Question

A 31 year-old African-American female presents with painful shin nodules, uveitis, and calcified hilar lymph nodes. A transbronchial biopsy of the lung would most likely show which of the following histologies?

Accepted Answer

Non-caseating granulomas

Answer

Golden-brown fusiform rods

Answer

Inflammation, fibrosis and cyst formation that is most prominent in subpleural regions

Answer

Silica particles (birefringent) surrounded by collagen

Answer

Patchy interstitial lymphoid infiltrate into walls of alveolar units

Pulmonary — MCQs

Pulmonary — MCQs

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