Which cell type predominates in a necrotic pulp with acute inflammation?

Correct answer: D. Polymorphonuclear leukocytes (neutrophils)

• A. Plasma cells are antibody-producing B-cell derivatives and are the signature of CHRONIC inflammation, prominent in periapical granulomas.
• B. Macrophages appear later in inflammation, clearing debris and orchestrating repair; they are abundant in chronic granulomatous tissue.
• C. Lymphocytes dominate in chronic lesions, mediating the cell-mediated and humoral responses that develop over weeks.
• D. CORRECT. POLYMORPHONUCLEAR NEUTROPHILS are the first responders of acute inflammation. They arrive within hours, phagocytose bacteria, and their lysosomal enzymes liquefy the tissue — producing the pus that characterises pulp necrosis and abscess formation. Their own death is what forms the purulent exudate.

Note: Acute = neutrophils. Chronic = lymphocytes, plasma cells, macrophages. A periapical granuloma is chronic granulation tissue, so expect the second group.