Under what condition would a sample be classified as granulomatous?

• A. When macrophages account for more than 15% of the total nucleated cell count
• B. If the sample contains necrotic tissue
• C. When lymphocytes are the predominant cell type
• D. If there are high levels of eosinophils

Answer: (A)

A sample is classified as granulomatous primarily when macrophages constitute a significant portion of the total nucleated cell count, specifically more than 15%. Granulomatous inflammation typically arises in response to persistent stimuli, such as infections or foreign substances, leading to a distinct histological pattern characterized by the aggregation of macrophages, which may transform into epithelioid cells. These macrophages play a vital role in the immune response, and their abundance in the sample is a key indicator of granulomatous inflammation.

The presence of necrotic tissue, predominance of lymphocytes, or high levels of eosinophils do not specifically indicate a granulomatous condition. Instead, these factors suggest different types of responses and conditions, such as necrotizing inflammation, reactive lymphoid hyperplasia, or allergic responses, respectively. Thus, the classification of a sample as granulomatous is fundamentally tied to the prominence of macrophages within that sample.