1 Pathological changes in asthma Lab. 3 rd year

2 PATHOLOGICAL FEATURES is characterized by the following images: 1.Mural inflammation (eosinophils, mast cells, lymphocytes) 2.Wall thickening by edema, hyperemia, fibrosis 3.Smooth muscle thickening 4.Mucous plugs 5.Epithelial slough

3 AIRWAY REMODLING Thickening of basement membranes. Eosinophilic inflammation, and edema in the walls of the bronchi. Smooth muscle hypertrophy Prominent mucous plugs. Desquamation of bronchial epithelium and metaplasia may occur

4 Bronchial asthma excessive mucus production.

5 Lung in Asthma with Mucous plugs

6 This cast of the bronchial tree is formed of inspissated mucus and was coughed up by a patient during an asthmatic attack. The outpouring of mucus from hypertrophied bronchial submucosal glands, the bronchoconstriction, and dehydration all contribute to the formation of mucus plugs that can block airways in asthmatic patients. Mucous plug in asthma:

7 Between the bronchial cartilage at the right and the bronchial lumen filled with mucus at the left is a submucosa widened by smooth muscle hypertrophy, edema, and inflammation (mainly eosinophils). Extrinsic asthma from type I hypersensitivity to allergens. The peripheral eosinophil count or the sputum eosinophils can be increased during an asthmatic attack.

8 Epithelial hyperplasia, goblet cell hyperplasia (most of the epithelial cells here are goblet cells. Normally only 20% of cells should be goblet type) Subepithelial collagenosis ("basement membrane thickening")(arrow)

9 Increased goblet cells

10 EOSINOPHILS, BM thickening & Epithelial hyperplasia

11 At high magnification, the numerous eosinophils are prominent from their bright red cytoplasmic granules in this case of bronchial asthma. There are two major clinical forms of asthma that can overlap.

12 SPUTUM 1. Eosinophils 2. Curschmann's spirals 3. Charcot-Leyden crystals

13 Bronchial asthma

14 eosinophils and Charcot-Leyden crystal

15 Eosinophilic needle-shaped crystalline structures. Represents breakdown products of eosinophils. Seen in asthma

16 Eosinophilic needle-shaped crystalline structures. Represents breakdown products of eosinophils. Seen in asthma

17 CURSCHMANN'S SPIRAL, MICRO - Spiral shaped mucous plug.

18 Mucous plugs with Curschmann's spiral--fuzzy spiraled structures, derived from mucus

19

20 – The hyperinflation is due to partial obstruction by asthma in a child with status asthmaticus..

21 Hyperinflated lungs of a patient who died with status asthmaticus.