Granulomatous Inflammation

The histopathology slide shown above displays a well-formed nodular aggregate of epithelioid histiocytes surrounded by a cuff of lymphocytes, without central necrosis. This morphological pattern is most characteristic of which type of granuloma?

A 52-year-old man from Rajasthan presents with a 6-month history of progressive weight loss, night sweats, and productive cough with blood-tinged sputum. On examination, he is cachectic with crackles in the right upper lobe. Chest X-ray shows a cavitary lesion in the right upper lobe with surrounding consolidation. Sputum smear microscopy is positive for acid-fast bacilli (AFB). A lung biopsy from the cavity wall shows caseating granulomas with central caseous necrosis surrounded by epithelioid cells and lymphocytes. What is the histological significance of the caseous necrosis in this lesion?

A 35-year-old farmer from Punjab presents with progressive dyspnea, cough, and constitutional symptoms for 3 months. Chest X-ray shows bilateral hilar lymphadenopathy with pulmonary infiltrates. Serum calcium is elevated at 11.8 mg/dL. Which investigation is most appropriate to confirm the diagnosis of sarcoidosis?

A 42-year-old woman presents with progressive dyspnea, bilateral hilar lymphadenopathy, and erythema nodosum. Chest X-ray shows a typical 'potato nodes' appearance. Transbronchial biopsy reveals non-caseating granulomas without acid-fast bacilli. What is the drug of choice for initial treatment of this condition?

A 38-year-old woman from rural Maharashtra presents with a 3-month history of progressive dyspnea, dry cough, and constitutional symptoms. Chest X-ray shows bilateral hilar lymphadenopathy with upper lobe infiltrates. Serum ACE level is elevated at 85 U/L (normal <40). Transbronchial lung biopsy reveals non-caseating granulomas. What is the most appropriate next step in management?