Pathology · patient case with 1 question
Biopsy showing acute and chronic inflammation of connective tissue
Scenario: A male patient had a biopsy which revealed INFLAMMATION OF CONNECTIVE TISSUE with ACUTE AND CHRONIC inflammatory cells.
Question 1
What is this associated with?
Show answer and explanation
Correct answer: B. Periapical granuloma
- A. A periapical (radicular) cyst is defined histologically by an EPITHELIAL LINING derived from the rests of Malassez surrounding a lumen; the description given makes no mention of epithelium.
- B. Correct. A PERIAPICAL GRANULOMA is granulation tissue at the apex of a non-vital tooth — inflamed CONNECTIVE TISSUE infiltrated by a mixture of chronic cells (lymphocytes, plasma cells, macrophages) with a variable ACUTE (neutrophil) component during exacerbations. Note that despite the name, it is NOT a true granuloma.
- C. A periodontal abscess is a localised collection of PUS within the periodontal pocket wall, arising from an existing periodontal pocket in a vital tooth.
- D. A gingival abscess is confined to the marginal or interdental gingiva, usually following impaction of a foreign body, and does not involve the attachment apparatus.
Note: Radiographically a granuloma and a radicular cyst CANNOT be distinguished — the diagnosis is histologic, and the presence or absence of an epithelial lining is what separates them.