NBME Answers : portland2020's page

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Can anyone further explain this?! I could eliminate a few item choices and I guessed correctly, just need more information! Thanks

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wired-in Patient has 5 yr h/o hep C, so it is chronic. Chronic inflammation is characterized by presence of lymphocytes & plasma cells while neutrophils is more characteristic of acute inflammation (Pathoma Ch. 2). AFP is within reference range so probably not HCC. Choice D, palisading lymphocytes & giant cells suggests granuloma which isn't typical of hep C. +51

almondbreeze Fa2019 pg 215, 217 on acute/chronic inflammation +2

popofo But doesn't AFP has not-so-high sensitivity for hepatocellular carcinoma (HCC)? If so, a negative result shouldn't be able to rule out HCC? +1

fatboyslim HCC from hepatitis C usually takes decades to occur. This patient has only had HCV infection for 5 yeats +1

portland2020 typically you would have a monocytic inflammatory infiltrate as described. The monocytes are an important component of the innate response. The monocytes can differentiate into macrophages. +