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Hypereosinophilia
0%
0/38
Reid Index > 50%
92%
35/38
Non-caseating granulomas
Evidence of a necrotizing infection
Keratin pearls
5%
2/38
Select Answer to see Preferred Response
The patient is suffering from chronic bronchitis and is, therefore, likely to have a Reid Index > 50% on histological examination. Chronic bronchitis results from persistent exposure to a lung irritant, such as cigarette smoke. The pollutant drives hypertrophy of mucous glands in the submucosa resulting in increasing production of mucous in the bronchi and bronchioles. The Reid Index is the ratio of the thickness of mucus glands relative to the overall bronchial/bronchiolar wall thickness, which is normally < 40%. In patients with chronic bronchitis, this value is increased to > 50%. Incorrect Answers: Answer 1: Hypereosinophilia would be consistent with an asthma exacerbation. Answer 3: Non-caseating granulomas are non-specific and could be seen in sarcoidosis, but would not be expected in chronic bronchitis Answer 4: Evidence of a necrotizing infection would be more consistent with an acute bacterial pneumonia. Answer 5: Keratin pearls would be consistent with squamous cell carcinoma.
3.7
(3)
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