Which of the following is the hallmark histological feature of chronic inflammation?
A. Granuloma formation in all cases of chronic inflammation
B. Massive edema with minimal cellular infiltrate
C. Predominance of neutrophils with fibrin deposition
D. Infiltration of mononuclear cells (lymphocytes, macrophages, and plasma cells)
Explanation
Hallmark of Chronic Inflammation
Key Point
The defining histological feature of chronic inflammation is the presence of mononuclear cell infiltration, primarily lymphocytes, macrophages (activated), and plasma cells.
Tissue damage: Often accompanied by tissue destruction and fibrosis
Angiogenesis: New blood vessel formation
Why Mononuclear Cells?
Mononuclear cells are recruited via chemokines (CCL2, CXCL10) and are capable of:
1.
Prolonged survival in tissue
2.
Sustained cytokine production
3.
Antigen presentation and adaptive immunity
4.
Tissue remodeling and fibrosis
Clinical Pearl
Granulomas (organized collections of epithelioid macrophages and lymphocytes) are a special form of chronic inflammation seen in TB, sarcoidosis, and fungal infections—not the hallmark of all chronic inflammation.
Mnemonic
MAC = Mononuclear cells, Activated macrophages, Chronic inflammation.
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