Which of the following is a major cell infiltrate in rheumatoid arthritis?

Correct Answer: Lymphocyte
Description: Ref. Robbins Pathology. 9th edition. Page. 1209 Rheumatoid Arthritis CD4+ T helper (TH) cells may initiate the autoimmune response in RA by reacting with an arthritogenic agent, perhaps microbial or a self-antigen IFN-γ from TH1 cells activates macrophages and resident synovial cells. IL-17 from TH17 cells recruits neutrophils and monocytes. TNF and IL-1 from macrophages stimulates resident synovial cells to secrete proteases that destroy hyaline cartilage. RANKL expressed on activated T cells stimulates bone resorption. Microscopy: The characteristic histologic features include Synovial cell hyperplasia and proliferation Dense inflammatory infiltrates (frequently forming lymphoid follicles) of cd4+ helper t cells, b cells, plasma cells, dendritic cells, and macrophages Increased vascularity due to angiogenesis Fibrinopurulent exudate on the synovial and joint surfaces; Osteoclastic activity in under- lying bone
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