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NBME 23 Answers

nbme23/Block 1/Question#29

A 34-year-old woman with a 5-year history of ...

Infiltration of lymphocytes, plasma cells, and macrophages

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submitted by docred123(3),

Can anyone further explain this?! I could eliminate a few item choices and I guessed correctly, just need more information! Thanks

wired-in  Patient has 5 yr h/o hep C, so it is chronic. Chronic inflammation is characterized by presence of lymphocytes & plasma cells while neutrophils is more characteristic of acute inflammation (Pathoma Ch. 2). AFP is within reference range so probably not HCC. Choice D, palisading lymphocytes & giant cells suggests granuloma which isn't typical of hep C. +15