A 52-year-old man with a 30-year history of occupational asbestos exposure presents to clinic with progressive dyspnea and pleuritic chest pain over the past 6 months. Vital signs are notable for tachypnea (RR 22/min) and mild hypoxemia (SpO2 89% on room air). Chest X-ray demonstrates bilateral lower lobe pleural thickening and pleural plaques. A transbronchial lung biopsy is performed. Light microscopy reveals numerous golden-brown, dumbbell-shaped structures with a distinctive refractile appearance contained within alveolar macrophages. These structures stain positive with Prussian blue stain. Which of the following best describes the composition and formation of these observed structures?

  1. A)Silicate particles from occupational exposure that have undergone fibrosis and calcification within macrophage granulomas
  2. B)Hemosiderin aggregates derived from chronic pulmonary hemorrhage that accumulate in tissue macrophages
  3. C)Asbestos fibers coated with a ferruginous layer of iron and protein (ferruginous bodies)GABARITO
  4. D)Talc granules surrounded by a foreign body giant cell reaction with iron oxide deposition
  5. E)Coal dust particles with surrounding anthracotic pigmentation and macrophage infiltration

Explicação

Ferruginous bodies are the hallmark histologic finding of asbestos exposure. They form when asbestos fibers are coated with a protein-iron complex secreted by alveolar macrophages attempting to phagocytose the fiber. This coating gives them their characteristi... Ver explicação completa e trilha adaptativa →

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