Gross appearance of cut surfaces of lung: The parenchyma was normal except for some apical scars and emphysema. The airways, however, showed the changes seen in this photo from another patient.

Gross features: The pulmonary arteries of this lung have been perfused with a white, barium-gelatin mixture. Note the airways. What is the diagnosis? Answer

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Consolidation does not account for the fact that the lungs did not collapse when the chest was opened. An obstructive airways disease (chronic bronchitis/bronchiolitis, emphysema, bronchiectasis, or asthma) must be the cause. The airways show thick, mucous plugs. Find at least three of these plugs. (One is just below the center.) The alveolar parenchyma appears normal.

The diagnosis is asthma.

Clinical summary Image 2

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