AIDS - granuloma

[maverick_pkg]

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BRS (page 33 ques 8) has a question where it says that in a HIV + patient with TUberculosis, epitheliod cells are an invariable feature.
Goljan in his audio lectures mentions that in HIV, helper T cells are so depleted that there is absoultely no chance of granuloma formation (reason : macrophages are not activated). as they aren't activated how does one INVARIABLY get epitheliod cells?

 

[Idiopathic]

The two are not mutually exclusive. Epitheliod cells can exist without granuloma formation, as they either giant cell conglomerations or histiocytes with extra cytoplasm. They are present in granulomas but are not defined by the presence of granulomas.

I know Goljan is correct, so this is my rationale for the BRS explanation.