Which histological finding reflects the airway remodeling that underlies irreversible component of airflow limitation in chronic asthma?

• A Dilated respiratory bronchioles filled with carbon laden macrophages
• B Whorled mucus plugs containing spiral strands of shed epithelium
• C Necrotizing granulomas with multinucleated giant cells in the bronchial wall
• D Subepithelial deposition of collagen causing thickening of the basement membrane ✓

Explanation

In chronic asthma, repeated injury drives subepithelial collagen deposition beneath the true basement membrane, producing the classic thickened basement membrane seen on light microscopy, together with goblet cell hyperplasia and bronchial smooth muscle hypertrophy. This remodeling accounts for fixed airflow obstruction. Curschmann spirals, whorls of mucus and shed epithelium found in sputum, reflect acute mucus plugging rather than structural remodeling. Granulomas suggest tuberculosis or sarcoidosis, and carbon laden macrophages describe coal macules.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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