A 45-year-old woman presents with progressive dyspnea, chronic productive cough, and recurrent chest infections. CXR shows tram-track opacities and ring shadows in the lower lobes. Which pathological finding is the hallmark of this condition?

• A Destruction of alveolar walls with airspace enlargement
• B Intraalveolar accumulation of PAS-positive lipoproteinaceous material
• C Diffuse interstitial fibrosis with honeycombing
• D Permanent dilation of bronchi and bronchioles ✓

Explanation

The clinical picture and tram-track opacities on CXR are classic for bronchiectasis. The pathological hallmark of bronchiectasis is permanent, abnormal dilation of bronchi and bronchioles due to destruction of elastic and muscular components of the bronchial wall. Option A describes emphysema. Option C describes UIP/IPF. Option B describes pulmonary alveolar proteinosis.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.