This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pathology
Not a characteristic feature of granuloma- 
Select and explain. 
A. PMN’s with fibrinoid necrosis with cellular infiltrates, B. Epitheloid cell, C. Chronic inflammatory infiltrate, D. Giant cell
A: PMN’s with fibrinoid necrosis with cellular infiltrates
Answer: A: PMN’s with fibrinoid necrosis with cellular infiltrates 
Explanation: Polymorphonuclear leucocytes or neutrophils have a major role in the acute inflammatory response. They are typically seen in acute inflammation.
While granuloma formation is seen during the chronic inflammatory response.
The cells predominating during chronic inflammatory response are lymphocytes, plasma cells, monocytes etc. PMN’s or neutrophils are typically absent during chronic inflammation.
Granuloma
It is an area of granulomatous inflammation.
It consists of i

Activated macrophages* i.e. epitheloid cells
Cells surrounding activated macrophages, these are :


Monocytes*
Lymphocytes* &
Plasma cells*


Langhans’ type giant cell* =>

It is a typical feature of epitheloid cell granuloma.
It is derived from the fusion of macrophages and characterized by 10-50 nuclei* around the periphery* of the cell.