47. Bronchial asthma

Overview of the slides

Staining: HE and PAS

Organ: Lung

Description:

Mucus plug and other characteristic alterations

The lung parenchyme is normal. However, the bronchus shows 6 alterations. Alteration 1, 2, 3 and 6 are PAS positive:

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

Diagnosis: Bronchial asthma

Goblet cell hyperplasia

Etiology:

• Hypersensitivity type 1 reaction

Theory:

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

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.

Mucous glands