Image Based Question-69954

A patient presents with history of paroxysms of dyspnoea, cough and wheezing. Histopathological examination of Lung (image on the left) and sputum examination is shown in the image.

What is the structure shown in image third ,marked by an arrow is made up of?

A. Parasites.

B. Mucus Plugs.

C. Eosinophils.

D. Mast cells.

Show Answer

Correct Answer » B Explanation

Ans:B. Mucus Plugs

The patient is suffering from Bronchial Asthma.

Image shows:

• First:Histopathological examination in Bronchial Asthma.
• Second:Charcot Leyden Crystals.
• Third:Curschmann’s spirals .

• Curschmann’s spirals are a microscopic finding in the sputum of asthmatics. They are spiral-shaped mucus plugs from subepithelial mucous gland ducts or bronchioles.

BRONCHIAL ASTHMA

MORPHOLOGIC FEATURES.

• Grossly, the lungs are overdistended due to over-inflation.
• The cut surface shows characteristic occlusion of the bronchi and bronchioles by viscid mucus plugs.

Microscopically, the following changes are observed:

• The mucus plugs contain normal or degenerated respiratory epithelium forming twisted strips called Curschmann’s spirals.

• The sputum usually contains numerous eosinophils and diamond-shaped crystals derived from eosinophils called Charcot-Leyden crystals.

• The bronchial wall shows thickened basement membrane of the bronchial epithelium, submucosal oedema and inflammatory infiltrate consisting of lymphocytes and plasma cells with prominence of eosinophils. There is hypertrophy of submucosal glands as well as of the bronchial smooth muscle.

• Changes of bronchitis and emphysema may supervene, especially in intrinsic asthma.