Apoptosis vs Necrosis MCQ — NEET PG Practice Question | NEETPGAI
Apoptosis vs Necrosis
medium
microscope Pathology
A 38-year-old woman with systemic lupus erythematosus (SLE) develops a skin biopsy showing extensive apoptosis of keratinocytes with formation of apoptotic bodies and minimal inflammatory response. In contrast, a 45-year-old man with acute hepatitis B presents with hepatocyte necrosis, cell swelling, and prominent macrophage infiltration. Which morphological feature BEST distinguishes apoptosis from necrosis in these two patients?
A. Cell swelling and increased cell volume
B. Cell shrinkage with intact nuclear and cytoplasmic membranes forming apoptotic bodies
C. Presence of macrophage infiltration and inflammatory exudate
D. Random fragmentation of chromatin without internucleosomal spacing
Explanation
Morphological Hallmark: Cell Size and Membrane Integrity
Core Morphological Distinction
Key Point
The morphological appearance of the dying cell — specifically cell size and the fate of membranes — is the BEST visual discriminator between apoptosis and necrosis under the microscope.
Apoptosis Morphology
Apoptosis is characterized by:
1.
Cell shrinkage (pyknosis) — nucleus becomes smaller and denser
2.
Membrane blebbing — outpouchings of the intact plasma membrane
3.
Formation of apoptotic bodies — membrane-bound fragments containing condensed chromatin
4.
Intact membranes — both nuclear and cytoplasmic membranes remain continuous until phagocytosis
5.
Minimal inflammation — no spillage of contents
Necrosis Morphology
Necrosis is characterized by:
1.
Cell swelling (oncosis) — cell volume increases due to loss of ion homeostasis
2.
Membrane rupture — plasma membrane breaks down early
3.
Nuclear changes — karyorrhexis (fragmentation) or karyolysis (dissolution)
On H&E histology, apoptotic bodies appear as small, round, membrane-bound fragments with condensed chromatin — they look like "mini-nuclei" scattered around. Necrotic cells look "blown up" and disorganized. This morphological difference is why pathologists can distinguish the two processes at 40× magnification.
Why Option 2 Is the Best Answer
Option 2 (cell shrinkage with intact membranes forming apoptotic bodies) encapsulates the ENTIRE morphological signature of apoptosis in a single phrase. It includes:
The size change (shrinkage, not swelling)
The membrane status (intact)
The resulting structure (apoptotic bodies)
This is the single most reliable morphological discriminator visible on routine histology.
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