47. Bronchial asthma

Staining: HE and PAS

Organ: Lung

Description:

The lung parenchyme is normal. However, the bronchus shows 6 alterations:

1. A mucus plug in the lumen
2. Goblet cell hyperplasia in the respiratory lumen
3. Thickened basement membrane
4. Lymphocytes, eosinophils in the sub-epithelial layer
5. Smooth muscle hypertrophy and hyperplasia
6. Mucus gland hyperplasia

Alteration 1, 2, 3 and 6 are PAS positive

Diagnosis: Bronchial asthma

Etiology:

• Hypersensitivity type 1 reaction

Theory:

The slide exists in both PAS and HE form. They’re both taken from the same preparation, at approximately the same height.

Asthma is a chronic inflammatory disorder of the airways that causes recurrent acute episodes of wheezing and cough. Intermittent and reversible airway obstruction is characteristic, along with eosinophilic inflammation of the bronchi, smooth muscle hypertrophy and hyperplasia and increased mucus production.

We can recognize that we’re looking at a bronchus by the presence of cartilage.

Recognize eosinophils for extra points on the exam.

Overview of the slides

Mucus plug and other characteristic alterations

Goblet cell hyperplasia

Mucous glands

Lymphocytes and plasma cells can also be seen, but I can’t recognize those.