A 40-year-old man has a chronic cough with fever for several months. The chest radiograph reveals a diffuse reticulonodular pattern. Microscopically on transbronchial biopsy, there are focal areas of inflammation containing epithelioid cell granuloma, Langhans giant cells, and lymphocytes. These findings are typical for which of the following type of hypersensitivity immunologic responses?
High-Yield Explanation
Presence of epitheloid cell granuloma, langhans giant cells and lymphocytes is characteristic of chronic granulomatous inflammation, which is associated with type IV hypersensitivity reaction.