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3028 Pathology

A 26-year-old man has had myalgias and a fever for the past week. On physical examination, his temperature is 38.6deg C. He has diffuse muscle tenderness, but no rashes or joint pain on movement. Laboratory studies show elevated serum creatine kinase and peripheral blood eosinophilia. Larvae of Trichinella spiralis are present within the skeletal muscle fibers of a gastrocnemius biopsy specimen. Two years later, a chest radiograph shows only a few small calcifications in the diaphragm. Which of the following immunologic mechanisms most likely contributed to the destruction of the larvae?

AAbscess formation with neutrophils
BAntibody-mediated cellular cytotoxicity (ADCC)
CComplement-mediated cellular lysis
DFormation of Langhans giant cells
Pathology
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3029 Pathology

A 40-year-old woman presents with a long history of vague upper abdominal pain and frequent indigestion. Physical examination reveals an obese woman with jaundice and abdominal tenderness. Serum bilirubin is elevated (4.2 mg/dL). There is a mild increase in serum AST and ALT (62 and 57 U/L, respectively) and a moderate increase in alkaline phosphatase (325 U/L). Markers for viral hepatitis are negative. Abdominal ultrasound examination shows echogenic stone-like material within the gallbladder and thickening of the gallbladder wall. An intrahepatic mass is also visualized adjacent to the gallbladder. A cholecystectomy is performed. Histologic examination shows dense fibrosis and glandular structures in the wall of the gallbladder. What is the most likely diagnosis?

ACarcinoma of the gallbladder
BHemangiosarcoma
CHepatic adenoma
DHepatocellular carcinoma
Pathology
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