All Sample Questions

Silicosis 1

Question

Vignette: A 30-year-old male presents to his physician with complaints of fatigue, shortness of breath, and a non-productive cough. He reports a history of smoking 1 pack of cigarettes per day for the past 10 years. On physical examination, the patient's lungs reveal bilateral crackles. A high-resolution computed tomography (HRCT) scan is performed and reveals interstitial lung disease. A lung biopsy is performed, and the pathology report indicates the presence of golden-brown, birefringent particles within macrophages and fibrotic interstitial tissues.

Question: What is the most likely histological finding in this patient's lung tissue?

Choices

A) Anthracotic pigment

B) Ferruginous bodies

C) Hemosiderin-laden macrophages

D) Lipofuscin-laden macrophages

E) Metastatic calcification

Answer

B) Ferruginous bodies

Explanation

The patient's symptoms and history of smoking point towards a diagnosis of interstitial lung disease, more specifically, asbestosis. Asbestos fibers, once inhaled, get lodged within the lung tissue, leading to fibrosis. On histological examination, these fibers are seen as golden-brown, birefringent particles under polarized light, indicative of asbestos. When these fibers are coated with iron-containing proteinaceous material, they form ferruginous bodies, which are pathognomonic for asbestosis. The other options listed do not match the clinical history and histological findings presented in the question. For example, anthracotic pigment is associated with coal dust exposure, hemosiderin-laden macrophages are seen in conditions involving recurrent bleeding into the alveoli, lipofuscin is a wear-and-tear pigment associated with aging, and metastatic calcification is seen in conditions causing hypercalcemia.