A 24-year-old man dies during a severe acute asthma attack. At autopsy, his lungs show overinflation, occlusion of bronchi by mucus plugs, Curschmann spirals, and numerous eosinophils. Which histological finding reflects chronic airway remodeling rather than the acute attack?
- A Subepithelial deposition of collagen causing basement membrane thickening ✓
- B Charcot-Leyden crystals within the mucus plugs
- C Eosinophilic infiltration of the bronchial mucosa
- D Bronchoconstriction of airway smooth muscle
Correct answer: A. Subepithelial deposition of collagen causing basement membrane thickening
Explanation
Chronic asthma produces structural remodeling: subepithelial collagen deposition thickening the basement membrane, hypertrophy of smooth muscle, mucous gland hyperplasia, and goblet cell metaplasia. Charcot-Leyden crystals are breakdown products of eosinophil granules and eosinophilic infiltrates reflect the acute allergic response, so they mark active inflammation, not remodeling. Bronchoconstriction is functional and reversible.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
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