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* Graft versus host Qs
  yelito61 - 10/31/06 22:37
  A gastric biopsy is performed on a patient with suspected graft-versus-host disease following bone marrow transplantation. The biopsy demonstrates many isolated dying epithelial cells in crypts showing fragmented, hyperchromatic nuclei and small discrete blebs containing both cytoplasm and nuclear fragments. The biopsy demonstrates which of the following?

A. Apoptosis
B. Caseous necrosis
C. Coagulative necrosis
D. Gangrenous necrosis
E. Liquefactive necrosis

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* Re:Graft versus host Qs
  kashmala - 10/31/06 22:39
  a or c
C also causes death of the cell thru apoptosis
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* Re:Graft versus host Qs
  vl2ss - 10/31/06 22:40
  A. Apoptosis
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* Re:Graft versus host Qs
  bep111 - 10/31/06 22:41
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* Re:Graft versus host Qs
  sage2006 - 10/31/06 22:44
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* Re:Graft versus host Qs
  yelito61 - 10/31/06 22:47
  A: is the correct answer.

The correct answer is A. The changes described are those of apoptosis, which is a form of programmed cell death. Apoptosis can be seen in a variety of settings. In this case, it is occurring in the context of graft-versus-host disease, which is mediated by CD8+ and CD4+ cells. Apoptosis also occurs during embryogenesis, during hormone-dependent involution in the adult (eg, during menstruation), during rapid proliferation of cell populations (eg, intestinal crypt epithelia), and in the immune system (e.g., in developing thymus). It can also occur after duct obstruction in organs such as pancreas and during some viral diseases. The hallmark of this programmed method of cell death is the fragmentation of the cell with formation of cytoplasmic blebs and apoptotic bodies that are phagocytized by other healthy cells.

Caseous necrosis (choice B) , such as is seen in tuberculosis, shows necrotic, amorphous granular debris surrounded by a granulomatous response.

Coagulative necrosis (choice C) , such as is seen in myocardial infarction, shows coagulated, anuclear cell "ghosts."

Gangrenous necrosis (choice D) is a commonly used surgical term (eg, in diabetic feet) that does not have a precise pathologic counterpart.

Liquefactive necrosis (choice E) is usually seen in focal tissue-destructive bacterial infection; a sterile liquefactive necrosis can also be observed in ischemic necrosis of the brain.
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* Re:Graft versus host Qs
  yelito61 - 10/31/06 22:49
  Fat necrosis is seen in Chronic Pancreatitis.  
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* Re:Graft versus host Qs
  yelito61 - 10/31/06 22:57
  Caseous necrosis is only seen in granulomatous infections as TB and Fungus infection.
In spite of the Sarcoidosis is a granulomatous disease doesn't have a caseous necrosis.

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