During a pathology seminar, the instructor discusses the histological features of a chronic inflammatory lesion. Which of the following is NOT a typical microscopic finding in chronic inflammation?

Question

Accepted Answer

C. Predominance of neutrophilic polymorphs with microabscesses. ## Histological Features of Chronic Inflammation

**Key Point:** Chronic inflammation is characterized by mononuclear cell infiltration (lymphocytes, macrophages, plasma cells) and tissue remodeling, NOT neutrophilic predominance.

### Microscopic Findings: Chronic vs. Acute Inflammation

| Finding | Acute Inflammation | Chronic Inflammation |
|---------|-------------------|----------------------|
| **Predominant cell** | Neutrophils (PMNs) | Lymphocytes, macrophages, plasma cells |
| **Microabscesses** | Common | Absent (unless secondary acute exacerbation) |
| **Fibroblasts** | Minimal | Prominent; active collagen synthesis |
| **Angiogenesis** | Minimal | Marked; new capillary formation |
| **Duration** | Hours to days | Weeks to years |
| **Tissue damage** | Exudative | Fibrotic, scarring |

### Why Option 0 is Incorrect

**High-Yield:** Neutrophilic polymorphs (PMNs) and microabscesses are hallmark features of **acute inflammation**, not chronic inflammation. Their presence suggests an active acute phase or secondary acute exacerbation superimposed on chronic disease.

**Clinical Pearl:** If you see neutrophils and microabscesses in a chronic lesion, think of acute-on-chronic inflammation (e.g., acute exacerbation of chronic osteomyelitis, or secondary bacterial infection of a chronic wound).

### Why the Other Options Are Correct

1. **Option 1** — Lymphocytes, macrophages, and plasma cells are the defining cellular infiltrate of chronic inflammation.
2. **Option 2** — Fibroblast proliferation and new collagen deposition are central to the reparative phase and tissue remodeling in chronic inflammation.
3. **Option 3** — Vascular proliferation (angiogenesis) is a hallmark of chronic inflammation, supporting the repair process and granulation tissue formation.

**Mnemonic:** **MAC-FAN** = **M**acrophages, **A**ngiogenesis, **C**ollagen (fibroblasts), **F**ibroblasts, **A**ctive repair, **N**o neutrophils (in pure chronic form).

Answer

A. Fibroblast proliferation and new collagen synthesis

Answer

B. Vascular proliferation with new capillary formation

Answer

D. Lymphocytic and macrophagic infiltration with plasma cells

During a pathology seminar, the instructor discusses the histological features of a chronic inflammatory lesion. Which of the following is NOT a typical microscopic finding in chronic inflammation?

Explanation

Histological Features of Chronic Inflammation

Microscopic Findings: Chronic vs. Acute Inflammation

Why Option 0 is Incorrect

Why the Other Options Are Correct

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Finding	Acute Inflammation	Chronic Inflammation
Predominant cell	Neutrophils (PMNs)	Lymphocytes, macrophages, plasma cells
Microabscesses	Common	Absent (unless secondary acute exacerbation)
Fibroblasts	Minimal	Prominent; active collagen synthesis
Angiogenesis	Minimal	Marked; new capillary formation
Duration	Hours to days	Weeks to years
Tissue damage	Exudative	Fibrotic, scarring