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?
- A)Silicate particles from occupational exposure that have undergone fibrosis and calcification within macrophage granulomas
- B)Hemosiderin aggregates derived from chronic pulmonary hemorrhage that accumulate in tissue macrophages
- C)Asbestos fibers coated with a ferruginous layer of iron and protein (ferruginous bodies)GABARITO
- D)Talc granules surrounded by a foreign body giant cell reaction with iron oxide deposition
- 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 →