A 40-year-old man was hospitalized for high fever and severe headache . A localized cavitary lesion was found in the brain by computerized tomography
A needle biopsy during exploratory craniotomy revealed that the lesion contained numerous neutrophils, many of which were dead or dying. This lesion most likely represents a(n)
A. abscess
B. caseous granuloma
C. noncaseous granuloma
D. gumma
E. malignant brain neoplasm
A
This lesion is an abscess, a localized purulent inflammation caused by bacteria . Abscesses are cavities filled with pus--an exudate composed of neutrophils, many of which are dead or dying. A granuloma is composed of epithelioid macrophages, lymphocytes, and multinucleated giant cells and typically does not contain pus. A gumma consists of macrophages, lymphocytes, multinucleated giant cells, and plasma cells and also does not contain neutrophils. No neoplastic cells were seen in this case, which excludes the diagnosis of neoplasm.
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