DAY 2 — CASE 13: What predominant type of inflammatory cell is found in a chronic periapical granuloma?

Correct answer: D. Lymphocytes

• A. Neutrophils are the PRIMARY cells in ACUTE inflammation (abscess, acute periapical abscess). Not chronic granuloma.
• B. Plasma cells (differentiated B lymphocytes producing antibodies) are also present in periapical granuloma but lymphocytes are more broadly the predominant chronic inflammatory cell.
• C. Mast cells are found in connective tissue and involved in allergic reactions; not the predominant cell in periapical granuloma.
• D. LYMPHOCYTES (along with plasma cells and macrophages) are the predominant cells in CHRONIC periapical granuloma. The granuloma consists of a core of chronic inflammatory cells (lymphocytes, plasma cells, macrophages) surrounded by fibrous connective tissue. Lymphocytes are cited as the predominant inflammatory cells.