A 30-year-old woman presents with recurrent episodes of wheezing and dyspnea triggered by aspirin use. Bronchoalveolar lavage shows eosinophilia. Lung biopsy during a severe attack would most likely show:

• A Granulomas with multinucleate giant cells
• B Mucus plugs containing eosinophils, Curschmann spirals, and Charcot-Leyden crystals ✓
• C Diffuse alveolar damage with hyaline membrane formation
• D Fibrinous pleuritis with subpleural consolidation

Explanation

In fatal or severe asthma (status asthmaticus), the airways are plugged with thick mucus containing shed epithelial cells, eosinophils, Curschmann spirals (inspissated mucus whorls), and Charcot-Leyden crystals (lysophospholipase from eosinophil granules). The bronchial walls show smooth muscle hypertrophy, basement membrane thickening, and goblet cell hyperplasia reflecting chronic remodeling. Aspirin-sensitive asthma (Samter triad) is driven by arachidonic acid shunting toward leukotrienes rather than prostaglandins.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.